Randomized Trial Comparing Ticagrelor and Aspirin Therapy for Preventing Recurrence in Mild Ischemic Stroke and High-Risk TIA Patients

What this Trial Is About

Researchers are evaluating the effects of different doses of ticagrelor combined with aspirin in patients who have had a non-disabling non-cardioembolic ischemic stroke or a high-risk transient ischemic attack TIA. This study is a randomized, controlled, outcome assessor-blinded pilot trial involving 100 patients admitted to Bou-Ali Sina Hospital in Sari, Iran. The goal is to compare how well a lower dose of ticagrelor plus aspirin over six months works versus a higher dose plus aspirin for one month in preventing stroke recurrence within a year. Participants are divided into two groups. The intervention group receives aspirin 325 mg initially and ticagrelor 180 mg, followed by aspirin 80 mg daily and ticagrelor 90 mg twice daily for one month, then a reduced ticagrelor dose of 60 mg twice daily with aspirin 80 mg daily until six months. The control group receives aspirin 325 mg and ticagrelor 180 mg initially, then aspirin 80 mg daily and ticagrelor 90 mg twice daily for one month, followed by aspirin 80 mg daily alone until six months. After six months, both groups continue on aspirin alone. Participants will have follow-up visits at months 1, 3, 6, and 12 with a neurologist or neurology resident. Clinical data such as stroke severity scores and disability measures will be recorded. Researchers will monitor stroke recurrence confirmed by brain imaging as the primary outcome over 12 months, along with major bleeding events and cardiovascular events as secondary outcomes. Safety and efficacy will be closely tracked throughout the study period.

Ticagrelor Based De-Escalation of Dual Antiplatelet Therapy in Ischemic Stroke