Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2026
Effect of insulin resistance on ticagrelor-versus clopidogrel-based dual antiplatelet therapy for secondary prevention of stroke in carriers of
Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph
Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04078737 (Clopidogrel With Aspirin in High-risk Patients With Acute Non-disabling Cerebrovascular Events II), which is not on this 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
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.
Clopidogrel With Aspirin in High-risk Patients With Acute Non-disabling Cerebrovascular Events II
Who cites it
1 citing paper in PubMed.
- Recent research progress on the mechanisms of clopidogrel resistance.European journal of clinical pharmacology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Jianhua ZhaoDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Xue TianDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Xiao YangDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Qin XuDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Xue XiaDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Yijun ZhangDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Xuewei XieDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Philip M BathDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Jing JingDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Yongjun WangDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Xia MengDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK. wanganxin@bjtth.org mengxia45@163.com.
Anxin WangDepartment of Neurology (Zhao), and Henan Joint International Laboratory of Neurorestoratology for Senile Dementia (Zhao), and Henan Key Laboratory of Neurorestoratology and Protein Modification (Zhao), First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China; Department of Neurology (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Tian, Yang, Xu, Xia, Zhang, Xie, Jing, Y. Wang, Meng, A. Wang), Beijing, China; Department of Epidemiology (Tian, Xu, Xia, A. Wang), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, and Department of Clinical Epidemiology and Clinical Trial (Tian, Yang, Xu, Xia, Zhang, A. Wang), Capital Medical University, Beijing, China; Stroke Trials Unit (Bath), Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK. wanganxin@bjtth.org mengxia45@163.com.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInsulin resistance is associated with increased platelet reactivity. We sought to investigate the effects of insulin resistance on dual antiplatelet therapy in
methodsWe conducted a post hoc analysis of the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II (CHANCE-2) trial, in which we randomized patients with minor stroke or TIA who carried
resultsAmong 4954 patients included, 3122 (63.0%) had high insulin resistance and 1832 (37.0%) had low insulin resistance. Compared with clopidogrel-ASA, ticagrelor-ASA reduced the risk of recurrent stroke in the low-insulin resistance group (71 [7.8%] v. 36 [3.9%]; hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.34 to 0.79), but not in the high-insulin resistance group (120 [7.7%] v. 120 [7.7%]; HR 0.96, 95% CI 0.74 to 1.24) (
interpretationIn
trial registrationClinicalTrials.gov, NCT04078737.
Indexed as
ClopidogrelCytochrome P-450 CYP2C19Insulin ResistanceIschemic Attack, TransientPlatelet Aggregation InhibitorsStrokeTicagrelorAgedAspirinDual Anti-Platelet TherapyFemaleHumansLoss of Function MutationMaleMiddle AgedSecondary PreventionAspirinClopidogrelCYP2C19 protein, humanCytochrome P-450 CYP2C19Platelet Aggregation InhibitorsTicagrelor
Identifiers
What OpenQuestion holds
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LicenceCC BY-NC-ND
Read underepoch 390
Registered trials
NCT04078737ClinicalTrials.gov
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.