Evidence map›Paper›PMID 41529869›Full record

ArticleJournal of neurointerventional surgery2026

Safety and efficacy of ticagrelor versus clopidogrel for carotid artery stenting: propensity score matched analysis.

Jay Kakadiya, Huanwen Chen, Arsh Patankar, Hamza A Salim, Muhammed Amir Essibayi, Pranjal Rai, Ahmed Y Azzam, Amelia K Adcock, Vivek S Yedavalli, Adam A Dmytriw and 4 more

Abstract read
In one paragraph

Article in Journal of neurointerventional surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

14 authors.

Jay Kakadiya *Division of Neuroradiology, Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland, USA.ORCID http://orcid.org/0009-0009-2075-6562
Huanwen Chen *Department of Neurology, University of Maryland Medical Center, Baltimore, Maryland, USA.ORCID http://orcid.org/0000-0003-2455-748X
Arsh PatankarSchool of Medicine, University of Oxford, Oxford, UK.
Hamza A SalimDepartment of Radiology, Division of Neuroradiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID http://orcid.org/0000-0002-5208-8425
Muhammed Amir EssibayiDepartment of Neurosurgery, Montefiore Medical Center, New York, New York, USA.ORCID http://orcid.org/0000-0001-8325-2382
Pranjal RaiDepartment of Radiology, Mayo Clinic, Rochester, Minnesota, USA.ORCID http://orcid.org/0009-0008-3796-8273
Ahmed Y AzzamDepartment of Neurosurgery, Montefiore Einstein Medical Center, New York, New York, USA.ORCID http://orcid.org/0000-0002-4256-0159
Amelia K AdcockDepartment of Neurology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA.
Vivek S YedavalliDivision of Neuroradiology, Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland, USA.ORCID http://orcid.org/0000-0002-2450-4014
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0003-0131-5699
Marco ColasurdoDepartment of Radiology, Oregon Health and Science University, Portland, Oregon, USA.ORCID http://orcid.org/0000-0002-7823-3088
Ajay MalhotraDepartment of Radiology, Yale University School of Medicine, New Haven, Connecticut, USA.ORCID http://orcid.org/0000-0001-9223-6640
Dheeraj GandhiDepartment of Neurosurgery, University of Maryland Medical Center, Baltimore, Maryland, USA.
Dhairya A LakhaniDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA dhairyalakhani@gmail.com.ORCID http://orcid.org/0000-0001-7577-1887

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI Laura F. Gibson · 2012 to 2026
$81.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

backgroundDual antiplatelet therapy (DAPT) is recommended around carotid artery stenting (CAS) to reduce periprocedural stroke risk. Clopidogrel is widely used, but response variability related to pharmacokinetics and CYP2C19 polymorphisms may limit its effectiveness. Ticagrelor is a more potent, direct acting P2Y12 inhibitor, but its comparative effectiveness in CAS remains uncertain.

methodsWe conducted a retrospective cohort study in the TriNetX database, identifying adults with carotid artery stenosis who underwent CAS between January 2016 and August 2025 and received either ticagrelor or clopidogrel. Primary outcomes at 180 days included ischemic stroke, major hemorrhage, intracranial hemorrhage, and all cause mortality. Secondary outcomes included inpatient readmission and emergency department (ED) visits. Propensity score matching (1:1), Kaplan-Meier survival, and Cox proportional hazards analysis were used.

resultsAmong 6996 patients, 378 received ticagrelor and 6618 received clopidogrel; aspirin co-use was similar (89.7% vs 91.7%). After matching, 377 patients remained in each cohort. Ischemic stroke (2.7% vs 4.2%; HR 0.56, 95% CI 0.25 to 1.27; P=0.159) and major hemorrhage (2.9% vs 4.8%; HR 0.61, 95% CI 0.29 to 1.30; P=0.197) were numerically lower with ticagrelor. Rates of intracranial hemorrhage were similar (2.7% vs 2.7%; HR 0.61, 95% CI 0.14 to 2.53; P=0.488). Mortality was numerically higher with ticagrelor (3.4% vs 2.7%; HR 1.64, 95% CI 0.68 to 3.97; P=0.263). ED visits were similar (14.3% vs 14.6%; HR 0.97, 95% CI 0.67 to 1.42; P=0.895). Inpatient readmission was numerically lower with ticagrelor (15.9% vs 19.1%; HR 0.81, 95% CI 0.57 to 1.14; P=0.223).

conclusionTicagrelor and clopidogrel showed comparable safety and effectiveness following CAS. Future prospective genotype informed trials are warranted to confirm these findings.

Indexed as

StentStroke

Identifiers

PMID41529869
PMCPMC13524145

What OpenQuestion holds

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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.