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NCT06653348 | RECRUITING | Ischemic Stroke


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

Mazandaran University of Medical Sciences

Information provided by (Responsible Party):

Athena Shariffi Raidi

Brief Summary:

This is a randomized, controlled, outcome assessor blind, parallel group design pilot study on 100 patient with diagnosis of ischemic stroke admitted in Bou-Ali Sina Hospital, Sari,Iran.The aim of study is to compare the efficacy of 90 mg ticagrelor BID plus aspirin for 1 month and 60 mg ticagrelor BID plus aspirin for 6 months in reduce of non-disabling non-cardioembolic ischemic stroke or high risk TIA recurrence during first 12 months.

Condition or disease

Ischemic Stroke

Transient Ischemic Attack

Intervention/treatment

Ticagrelor 60 + Aspirin

Ticagrelor 90 + aspirin

Phase

PHASE2

PHASE3

Detailed Description:

This is a randomized, controlled, parallel, outcome assessor blind, feasibility study. The aim of study is assess the efficacy of ticagrelor de-escalation in reduce of non-disabling non-cardioembolic ischemic stroke or high risk TIA recurrence during first 12 months after primary event. 100 patient with diagnosis of ischemic stroke admitted in Bou-Ali Sina Hospital, Sari, Iran will be randomized to intervention or control group by using 4 block randomization method. Inclusion criteria is : age\>40, signing inform consent, recent ischemic stroke within 24 h, diagnosed by brain CT or MRI mild stroke with NIHSS =\<8 and no evidence of large infarct in brain imaging.,high risk TIA with ABCD \>4, no cardioembolic source such as low E/F, MS, AF ,... no specific etiology such as dissection, vasculitis, ... no carotid stenosis \> 50 % in side of involvement. Exclusion criteria is :history of hypersensitivity to consumptive drug any indication for anticoagulant therapy acute phase treatment with intravenous thrombolysis or thrombectomy any contraindication for consumptive drug history of intracranial hemorrhage history of GI bleeding during past 6 m candidate for endarterectomy history of coagulopathy active hemorrhagic diathesis during randomization. Patients in control group will be treat with standard ischemic stroke regiment including ASA 325 mg stat and ticagrelor 180 mg stat, then ASA 80 mg and ticagrelor 90 mg BID for 1 month. Then single antiplatelet therapy with ASA will be continue. Intervention group will be treat with ASA 325 mg stat and ticagrelor 180 mg stat, then ASA 80 mg daily and ticagrelor 90 mg BID for 1 month. And, Ticagrelor 60 mg BID plus ASA 80 mg daily until the end of month 6. Then single antiplatelet therapy with ASA will be continue. Four fallow up visit plan by a neurologist or neurology resident on month 1, 3, 6 and 12.Clinical data including NIHSS score, MRS score and other data will record on case report form. Stroke recurrence or cardiovsacular event is efficacy end point. Major bleeding according to STIH criteria is study safety end point. Primary outcome is ischemic stroke recurrence during first 12 months after first event documented by new lesion on brain CT or MRI. Secondary outcome is major hemorrhagic events, stroke recurrence during first 6 months and any cardiovascular event during first 12 month.

Study Type : INTERVENTIONAL
Estimated Enrollment : 100 participants
Masking : SINGLE
Masking Description : This study designed to be blind to the outcome assessors, meaning that the neurologist evaluating the patients' outcomes was unaware of the treatment assignments.
Primary Purpose : PREVENTION
Official Title : De-Escalation of Dual Antiplatelet Therapy With Ticagrelor and Aspirin in Non-disabling Non-cardioembolic Ischemic Stroke or High Risk TIA Patients: A Randomized, Outcome Assessor Blind, Controlled Trial
Actual Study Start Date : 2024-04-01
Estimated Primary Completion Date : 2026-07-01
Estimated Study Completion Date : 2026-08-01

Information not available for Arms and Intervention/treatment

Ages Eligible for Study: 40 Years
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers: 1
Criteria
Inclusion Criteria
  • * signing inform consent,
  • * recent ischemic stroke within 24 h,
  • * diagnosed by brain CT or MRI mild stroke with NIHSS =\<8 and no evidence of large infarct in brain imaging
  • * high risk TIA with ABCD \>4,
  • * no cardioembolic source such as low E/F, MS, AF ,...
  • * no specific etiology such as dissection, vasculitis, ...
  • * no carotid stenosis \> 50 % in side of involvement
Exclusion Criteria
  • * history of hypersensitivity to consumptive drug
  • * any indication for anticoagulant therapy
  • * acute phase treatment with intravenous thrombolysis or thrombectomy
  • * any contraindication for consumptive drug
  • * history of intracranial hemorrhage
  • * history of GI bleeding during past 6 m
  • * candidate for endarterectomy
  • * history of coagulopathy
  • * active hemorrhagic diathesis during randomization

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

Location Details

NCT06653348


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Locations


RECRUITING

Iran, Islamic Republic of, Mazandaran

Mazandaran Province, Sari, Iran

Sari, Mazandaran, Iran, Islamic Republic of, 4817844718

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