Ticagrelor, aspirin benefits in TIA outweigh risk over 30-day treatment period: Neurology

China: A recent study in the journal Neurology found that in patients with mild to moderate ischemic stroke or at high risk for transient ischemic attack (TIA), the ischemic benefit of ticagrelor-aspirin outweighs the risk of major hemorrhage throughout the 30-day treatment period. Also, the treatment effect of ticagrelor-aspirin was shown to be present from the first week. 

The study was conducted by Yongjun Wang, China National Clinical Research Center for Neurological Diseases, Beijing, China, and colleagues with the objective to investigate the short-term time course benefit and risk of ticagrelor with aspirin in acute mild-moderate ischemic stroke or high-risk TIA in the THALES trial. 

In an exploratory analysis of the THALES trial (The Acute Stroke or Transient Ischemic Attack Treated with Ticagrelor and ASA for Prevention of Stroke and Death), the researchers evaluated the cumulative incidence of irreversible safety and efficacy outcomes at different timepoints during the 30-day treatment period.

Major ischemic events defined as a composite of ischemic stroke or non-hemorrhagic death was the efficacy outcome. The safety outcome was major hemorrhage defined as a composite of intracranial hemorrhage and fatal bleeding. Combination of these two endpoints was used to define net clinical impact.