Trial reportStroke2020
Ticagrelor Added to Aspirin in Acute Nonsevere Ischemic Stroke or Transient Ischemic Attack of Atherosclerotic Origin.
Trial report in Stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03354429 (A Randomised, Double-Blind, Placebo-Controlled, International, Multicentre, Phase III Study to Investigate the Efficacy and Safety of Ticagrelor and ASA Compared With ASA in the Prevention of Stroke and Death in Patients With Acute Ischaemic Stroke or Transient Ischaemic Attack), which is not on this map. Cited by 48 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomised, Double-Blind, Placebo-Controlled, International, Multicentre, Phase III Study to Investigate the Efficacy and Safety of Ticagrelor and ASA Compared With ASA in the Prevention of Stroke and Death in Patients With Acute Ischaemic Stroke or Transient Ischaemic Attack
Who cites it
48 citing papers in PubMed, 1 synthesis or guideline pooled it, 98 citations in OpenAlex.
- Contemporary antiplatelet therapy for secondary stroke prevention: a narrative review of current literature and guidelines.Stroke and vascular neurology · 2022Pooled it
- Dual antiplatelet therapy with ticagrelor vs clopidogrel in patients with TIA or minor stroke with or without symptomatic carotid artery stenosis: a post hoc analysis of the CHANCE-2 trial.Stroke and vascular neurology · 2025Trial
- Early Neurologic Deterioration and Efficacy of Dual Antiplatelet in Anterior Versus Posterior Circulation Stroke.Journal of the American Heart Association · 2025Trial
- Dual Antiplatelet Therapy and Outcomes in Acute Mild to Moderate Stroke With Versus Without Large-Artery Atherosclerosis Post Hoc Analysis of ATAMIS.Journal of the American Heart Association · 2024Trial
- Ticagrelor Versus Clopidogrel in Minor Stroke or Transient Ischemic Attack With Intracranial Artery Stenosis: A Post Hoc Analysis of CHANCE-2.Journal of the American Heart Association · 2023Trial
- Genotype-Guided Dual Antiplatelet Therapy in Minor Stroke or Transient Ischemic Attack With a Single Small Subcortical Infarction.Neurology · 2023Trial
- Trial
- Efficacy and Safety of Ticagrelor and Aspirin in Patients With Moderate Ischemic Stroke: An Exploratory Analysis of the THALES Randomized Clinical Trial.JAMA neurology · 2021Trial
- Carotid Stenosis and Recurrent Ischemic Stroke: A Post-Hoc Analysis of the POINT Trial.Stroke · 2021Trial
- Tirofiban for Branch Atheromatous Disease-Related Stroke: The STRATEGY Randomized Clinical Trial.JAMA neurology · 2026Article
- Secondary prevention of recurrent ischemic stroke: from guidelines to precision medicine.Journal of cardiothoracic surgery · 2026Review
- Aspirin-ticagrelor use after mild acute ischemic stroke: Findings from the get with the guidelines-stroke registry.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2026Article
- Residual early neurological deterioration following dual antiplatelet in stroke: post hoc analysis of the ATAMIS trial.Therapeutic advances in neurological disorders · 2026Article
- Epidemiology, Pathophysiology, and Medical Management of Intracranial Atherosclerotic Disease.Journal of neuroendovascular therapy · 2026Review
- Purinergic receptors in atherosclerosis: implications for pathophysiology and therapeutic strategies.Journal of physiology and biochemistry · 2025Review
- Targeted drug delivery systems for atherosclerosis.Journal of nanobiotechnology · 2025Review
- Real-World Dual Antiplatelet Therapy Use Exceeds Randomized Trials Boundaries With Possible Safety Issues in Patients With Large Artery Atherosclerosis-Insights From the READAPT Study.European journal of neurology · 2025Observational
- Therapeutic effect and psychological impact of aspirin plus edaravone on patients with cerebral infarction.World journal of psychiatry · 2024Article
- Management of ischaemic stroke survivors in primary care setting: the road to holistic care.Internal and emergency medicine · 2024Review
- Tirofiban combined with Aspirin in the Treatment of Acute Penetrating Artery Territory Infarction (STRATEGY): protocol for a multicentre, randomised controlled trial.Stroke and vascular neurology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeAmong patients with a transient ischemic attack or minor ischemic strokes, those with ipsilateral atherosclerotic stenosis of cervicocranial vasculature have the highest risk of recurrent vascular events.
methodsIn the double-blind THALES (The Acute Stroke or Transient Ischemic Attack Treated With Ticagrelor and ASA for Prevention of Stroke and Death) trial, we randomized patients with a noncardioembolic, nonsevere ischemic stroke, or high-risk transient ischemic attack to ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2-30) or placebo added to aspirin (300-325 mg on day 1 followed by 75-100 mg daily for days 2-30) within 24 hours of symptom onset. The present paper reports a prespecified analysis in patients with and without ipsilateral, potentially causal atherosclerotic stenosis ≥30% of cervicocranial vasculature. The primary end point was time to the occurrence of stroke or death within 30 days.
resultsOf 11 016 randomized patients, 2351 (21.3%) patients had an ipsilateral atherosclerotic stenosis. After 30 days, a primary end point occurred in 92/1136 (8.1%) patients with ipsilateral stenosis randomized to ticagrelor and in 132/1215 (10.9%) randomized to placebo (hazard ratio 0.73 [95% CI, 0.56-0.96],
conclusionsIn this exploratory analysis comparing ticagrelor added to aspirin to aspirin alone, we found no treatment by ipsilateral atherosclerosis stenosis subgroup interaction but did identify a higher absolute risk and a greater absolute risk reduction of stroke or death at 30 days in patients with ipsilateral atherosclerosis stenosis than in those without. In this easily identified population, ticagrelor added to aspirin provided a clinically meaningful benefit with a number needed to treat of 34 (95% CI, 19-171). Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03354429.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.