{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T08:33:37Z","timestamp":1775205217393,"version":"3.50.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>It is unclear whether infarct location affects stroke recurrence after index ischemic stroke. We aimed to compare the risk of stroke recurrence and the responses to dual antiplatelets with ticagrelor-aspirin versus clopidogrel-aspirin between patients with posterior circulation infarct (PCI) and those with anterior circulation infarct (ACI) after minor stroke or transient ischemic attack.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Data were obtained from the double-blind CHANCE-2 trial (Ticagrelor or Clopidogrel With Aspirin in High-Risk Patients With Acute Nondisabling Cerebrovascular Events II), which was conducted across 202 centers in China from September 2019 to March 2021. Patients with positive diffusion-weighted imaging were included and classified into PCI and ACI groups according to the hyperintense lesions on diffusion-weighted imaging. The primary efficacy and safety outcomes were a new stroke and severe or moderate bleeding within 90 days, respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              A total of 4168 patients were included in this substudy, with 1427 PCI and 2741 ACI. During the 90-day follow-up, the risk of stroke recurrence in patients with PCI was similar to that with ACI (7.4% versus 8.3%; adjusted hazard ratio, 1.01 [95% CI, 0.79\u20131.29];\n              <jats:italic>P<\/jats:italic>\n              =0.94). In comparison with clopidogrel-aspirin, ticagrelor-aspirin significantly reduced the risk of stroke recurrence in both the PCI (hazard ratio, 0.59 [95% CI, 0.40\u20130.89];\n              <jats:italic>P<\/jats:italic>\n              =0.01) and ACI groups (hazard ratio, 0.65 [95% CI, 0.50\u20130.85];\n              <jats:italic>P<\/jats:italic>\n              =0.002). There was no treatment-by-infarct location interaction (\n              <jats:italic>P<\/jats:italic>\n              value for interaction, 0.92). The risk of severe or moderate bleeding was similar between PCI and ACI patients (\n              <jats:italic>P<\/jats:italic>\n              =0.19). However, the risk of any bleeding increased on ticagrelor-aspirin than clopidogrel-aspirin treatment in PCI and ACI patients (\n              <jats:italic>P<\/jats:italic>\n              =0.02 and 0.002, respectively).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Our study demonstrated that stroke recurrence was similar between PCI and ACI in patients with minor stroke or transient ischemic attack. Additionally, ticagrelor-aspirin was superior to clopidogrel-aspirin in reducing the risk of stroke within 90 days in both PCI and ACI patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04078737.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.122.041738","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T18:00:50Z","timestamp":1679940050000},"page":"964-972","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Stroke Recurrence and Antiplatelets in Posterior Versus Anterior Circulation Minor Stroke or Transient Ischemic Attack"],"prefix":"10.1161","volume":"54","clinical-trial-number":[{"clinical-trial-number":"nct04078737","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4761-2800","authenticated-orcid":true,"given":"Huihui","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.), Capital Medical University, China."},{"name":"Department of Neurology and Clinical Research Center of Neurological Disease, Second Affiliated Hospital, Soochow University, China (H.L.)."},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9822-5758","authenticated-orcid":true,"given":"Jing","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.), Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4351-2877","authenticated-orcid":true,"given":"Anxin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.), Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8039-709X","authenticated-orcid":true,"given":"Qin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.), Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8764-9739","authenticated-orcid":true,"given":"Xia","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.), Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.), Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-5418","authenticated-orcid":true,"given":"Zixiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.), Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.)."},{"name":"Chinese Institute for Brain Research, Beijing, China (Z.L., Y.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-2341","authenticated-orcid":true,"given":"Yongjun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.), Capital Medical University, China."},{"name":"Advanced Innovation Center for Human Brain Protection (Y.W.), Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing (H.L., J.J., A.W., Q.X., X.M., H.L., Z.L., Y.W.)."},{"name":"Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China (Y.W.)."},{"name":"Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Beijing, China 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