cover image: Differential effect of ticagrelor versus clopidogrel by homocysteine levels on risk of recurrent stroke: a post hoc analysis of the CHANCE-2 trial

20.500.12592/rxwdhr9

Differential effect of ticagrelor versus clopidogrel by homocysteine levels on risk of recurrent stroke: a post hoc analysis of the CHANCE-2 trial

1 Feb 2024

severe stroke [stroke with subsequent MRS score of 4 or 5], We aimed to investigate the effect of homocysteine levels on moderate stroke [stroke with subsequent MRS score of 2 or 3], the efficacy and safety of ticagrelor–ASA versus clopidogrel– mild stroke [stroke with subsequent MRS score of 0 or 1], TIA, ASA among patients with minor ischemic stroke or TIA who and no stroke or TIA). [...] Levels formed shift analysis for comparison of the secondary outcome of total homocysteine were measured with the enzymatic method of ordinal stroke or TIA between the 2 treatment groups with in the clinical laboratory in Beijing Tiantan Hospital by laboratory the use of logistic regression, and we calculated the common personnel unaware of the clinical data. [...] of patients randomly assigned to the 2 treatment groups, patients The primary safety outcome of severe or moderate bleeding excluded because of missing homocysteine levels, and patients with occurred with similar frequency in the ticagrelor–ASA group and low and high homocysteine levels are shown in Figure 1. [...] The post hoc 2 1391 1331 1324 1113 analysis of the VITATOPS trial showed a significant interaction between B vitamins and antiplatelet therapy.38 Of the participants taking antiplatelet drugs at baseline, B vitamins had no significant Figure 2: Cumulative probability of stroke according to homocysteine effect on the risk of recurrent stroke, but a significant effect was seen levels and treatment. [...] tives, and the members of the survey teams at the 202 centres of the 45.
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Canada