Evidence map›Paper›PMID 39222701›Full record

Trial reportJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2024

Time to treatment and disability attributed to index stroke in the POINT trial.

Pargol Balali, J Donald Easton, S Claiborne Johnston, Brett Cucchiara

Registry-linked trialAbstract readRandomized Controlled TrialComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00991029 (Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT00991029 phase3terminatednot on this map

Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trial

TypeinterventionalSponsorUniversity of California, San FranciscoRan2010 to 2018Enrolled4,881ConditionsIschemic Attack, TransientArmsClopidogrel, placebo
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Pargol BalaliDepartment of Neurology, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: pargol.balali@pennmedicine.upenn.edu.
J Donald EastonDepartment of Neurology, University of California, San Francisco, USA. Electronic address: JDonaldEaston@ucsf.edu.
S Claiborne JohnstonDepartment of Neurology, University of California, San Francisco, USA; Harbor Health, Austin, TX, USA. Electronic address: clay.johnston@harborhealthteam.com.
Brett CucchiaraDepartment of Neurology, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: cucchiar@pennmedicine.upenn.edu.

Funding

POINT: PLATELET-ORIENTED INHIBITION IN NEW TIAU01NS062835 · NINDS · UNIVERSITY OF TEXAS AT AUSTIN · PI EASTON, J. DONALD, ELM, JORDAN J. · 2009 to 2017
$56.0M
Neurologic Emergencies Treatment Trials Network: Clinical Coordinating CenterU01NS056975 · NINDS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BARSAN, WILLIAM G · 2006 to 2015
$40.4M
Neurological Emergencies Treatment Trials Network Statistical and Data ManagementU01NS059041 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI DURKALSKI, VALERIE L, PALESCH, YUKO Y · 2006 to 2015
$9.1M
The Philadelphia Regional Stroke Trials Network Coordinating Center (PRSTNCC)U24NS107224 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI Brett Lee Cucchiara · 2018 to 2026
$3.2M
NINDS NIH HHS U01 NS056975NINDS NIH HHS U01 NS059041NINDS NIH HHS U01 NS062835NINDS NIH HHS U24 NS107224
6 · The paper itself

Abstract

backgroundIn the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial, dual antiplatelet therapy (DAPT) was associated with reduced disability attributable to the index stroke compared to antiplatelet monotherapy. However, it is unknown whether earlier treatment with DAPT versus aspirin is associated with greater benefit.

methodsWe analyzed patients enrolled in POINT with minor ischemic stroke who had available data recording the treatment initiation time and modified Rankin Scale (mRS) at 90 days. Patients were randomized to DAPT (aspirin plus clopidogrel) vs. aspirin alone within 12 h of symptom onset. We estimated the effect of DAPT on disability (defined as mRS>1) ascribed to the index event and major hemorrhage at 90 days, stratified by tertiles of time from symptom onset-to-treatment-initiation.

resultsA total of 2559 patients were included; median onset-to-treatment-initiation time was 8.3 h (IQR:5.8-11.0). Comparing DAPT to aspirin, the rate of disability attributed to the index event at 90-day follow-up was 5.1 % vs. 8.6 % (OR 0.57; 95 % CI:0.33-0.99) in patients treated <6.7 h, 7.5 % vs. 9.9 % (OR 0.74; 95 % CI:0.45-1.19) in those treated 6.7-10.0 h, and 8.6 % vs. 10.6 % (OR 0.80; 95 % CI:0.50-1.26) in those treated >10.0 h after symptom onset (p for interaction=0.65). There was no difference in major hemorrhage across time strata.

conclusionsWhile not statistically significant, these results suggest the possibility of greater efficacy at reducing disability ascribed to minor stroke with earlier treatment with DAPT compared to aspirin. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Identifier: NCT00991029.

Indexed as

AspirinClopidogrelDisability EvaluationDual Anti-Platelet TherapyFunctional StatusIschemic StrokePlatelet Aggregation InhibitorsTime-to-TreatmentAgedFemaleHumansIschemic Attack, TransientMaleMiddle AgedRecovery of FunctionRisk FactorsAspirinClopidogrelPlatelet Aggregation InhibitorsAspirinClopidogrelDual anti-platelet therapyIschemic strokeStroke

Identifiers

PMID39222701
PMCPMC13456534

What OpenQuestion holds

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Read underepoch 390

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.