A Randomized Trial Comparing Aspirin Combined With Ticagrelor or Cilostazol for Treating Large-vessel Minor Stroke or Transient Ischemic Attack in Adults

What this Trial Is About

Researchers are evaluating the safety and effectiveness of two different drug combinationsticagrelor with aspirin versus cilostazol with aspirinin adults who have experienced their first-ever large-vessel minor ischemic stroke or transient ischemic attack TIA. This phase 3 randomized controlled trial aims to compare these treatments in reducing the risk of new strokes and assess their safety regarding bleeding complications. The study is sponsored by Kafrelsheikh University and was approved by the ethics committee of the faculty of medicine at Kafr el-Sheik University. Participants are randomly assigned to one of two groups the ticagrelor arm receives a 180 mg loading dose within 24 hours of stroke onset followed by 90 mg twice daily from day 2 to day 90, along with a loading dose of 300 mg aspirin and a maintenance dose of 75 mg aspirin. The cilostazol arm receives a 200 mg loading dose within 24 hours followed by 100 mg twice daily from day 2 to day 90, also combined with aspirin given in the same manner. Both groups are followed up for 90 days to monitor treatment effects and safety. Throughout the study, participants undergo clinical assessments including history, neurological exams, and stroke severity scales such as NIHSS on admission and day 7, plus the Modified Rankin Scale at one week and three months. Imaging tests like brain CT and MRI, along with blood tests and heart monitoring, are performed as needed. Researchers measure outcomes including the rate of new strokes, bleeding events, and adverse drug effects, as well as overall functional recovery and vascular events over the 90-day follow-up period.

Combining Aspirin With Ticagrelor or Cilostazol in Large-vessel Minor Stroke or TIA