Actively Recruiting
Effect of Genotype-Guided Oral P2Y12 Inhibitor Selection vs Conventional Clopidogrel Therapy in Symptomatic ICAD
Led by Sunnybrook Health Sciences Centre · Updated on 2025-11-20
100
Participants Needed
2
Research Sites
94 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Stroke is an important cause of death, disability, and memory problems in adults. The build-up of plaque in arteries inside the brain is known as "intracranial atherosclerotic disease" or "ICAD" for short, and can reduce blood flow in the brain. Clopidogrel is a medicine used to prevent strokes because it stops blood from clotting. However, there are some people who do not get as much benefit from Clopidogrel because of differences in their genes; they have a variation in a certain gene and their body is not able to properly process Clopidogrel. Another medication called Ticagrelor can benefit people who have this genetic variation. The study investigators will randomize patients who have had a stroke due to ICAD to receive genetic testing, or standard of care. The standard-of-care group will take Clopidogrel for 90 days. The genetic testing group will complete a genetic test to see if they can properly process Clopidogrel. Depending on the results of the genetic test, patients will either take Clopidogrel or Ticagrelor for 90 days. All patients will have a brain scan at baseline and 90 days to see if they had any new strokes. Patients will also complete tests and questionnaires about function and memory at baseline and 90 days. This study will be one of the first to see if it is feasible and safe to use genetic testing to help choose medications for patients who have had a stroke. This will help the study investigators design a larger study that can test if genetic testing in stroke patients reduces future stroke risk and improves health outcomes.
CONDITIONS
Official Title
Effect of Genotype-Guided Oral P2Y12 Inhibitor Selection vs Conventional Clopidogrel Therapy in Symptomatic ICAD
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age 40 years or older, male or female
- Experienced a transient ischemic attack or ischemic stroke caused by 30-99% narrowing in brain arteries within the last 30 days
- Clinical need for dual antiplatelet therapy for at least 3 months
- Stroke or TIA due to symptomatic atherosclerotic narrowing in intracranial arteries shown by CT or MR angiography
You will not qualify if you...
- Any reason preventing use of dual antiplatelet therapy
- Contraindications to clopidogrel or ticagrelor, including pregnancy
- Need for long-term blood thinners such as for atrial fibrillation or mechanical heart valve
- Complete blockage (100% stenosis) of brain arteries causing stroke
- Brain artery narrowing caused by reasons other than atherosclerosis
- Carotid artery disease needing surgery
- Blood clots inside arteries
- Unstable subdural hematoma within past 12 months
- Previous spontaneous bleeding stroke
- Head injury causing brain bleeding within past month
- Living in nursing home or needing daily nursing or help with activities
- Brain tumors (except meningioma) or vascular malformations
- Life expectancy under 6 months
- Participation in another conflicting study
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Trial Site Locations
Total: 2 locations
1
University of Calgary
Calgary, Alberta, Canada
Not Yet Recruiting
2
Dr. Mark I. Boulos - Sunnybrook Health Sciences Centre
Toronto, Ontario, Canada, M4N3M5
Actively Recruiting
Research Team
M
Mark I Boulos, MD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
Not the Right Trial for You?
Explore thousands of other clinical trials that might be a better match.
Sign up to get personalized trial recommendations delivered to your inbox.
Already have an account? Log in here