Wang Y, Meng X, Wang A, et al. - Treatment with ticagrelor, compared with clopidogrel, modestly lowered the risk of stroke at 90 days in Chinese patients with minor ischemic stroke or transient ischemic attack (TIA) who were carriers of CYP2C19 loss-of-function alleles. Total bleeding events were more with ticagrelor vs clopidogrel.

• A randomized, double-blind, placebo-controlled trial at 202 centers wherein patients with a minor ischemic stroke or TIA who carried CYP2C19 loss-of-function alleles were enrolled (n=6,412).

• Patients were given ticagrelor and placebo clopidogrel (n=3,205) or clopidogrel and placebo ticagrelor (n=3,207); both groups were treated with aspirin for 21 days.

• Within 90 days, occurrence of stroke was evident in 6.0% vs 7.6% of patients in the ticagrelor group vs clopidogrel group, respectively (hazard ratio, 0.77).

• In the ticagrelor group, 0.3% of patients experienced severe or moderate bleeding, vs 0.3% in the clopidogrel group; any bleeding occurred in 5.3% vs 2.5%, respectively.