Aspirin and ticagrelor - are they for minor stroke or Transient Ischemic Attack?
L-R: Prof Thanh Phan, Prof Henry Ma
Monash study shows aspirin and ticagrelor have a higher probability of being the superior treatment among patients with minor stroke than those with Transient Ischemic Attack (TIA). It uses a complex statistical method known as Bayesian network metaanalysis to permit comparison of different drug regimes when there are no direct head to head comparison trials.
This meta-analysis of 5 dual antiplatelet therapy (DAPT) trials examining treatment for high-risk transient ischemic attack (TIA) and minor stroke among 28,148 patients showed that aspirin (acetylsalicylic acid) and ticagrelor had a 94% probability of being a superior treatment for minor stroke and a 60% probability as being the superior treatment for TIA. Importantly, the data provided here have not been published previously.
This study, conducted in collaboration with the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China and University of California, San Francisco, USA (CJ), provides clear evidence on the use of DAPT in the first 24 hours for minor stroke in reducing recurrence. It was performed by Dr Andy Lim, PhD candidate and under supervision of Professor Thanh Phan and Professor Henry Ma.
Study Lead and Co-Director of Stroke and Ageing Research Group, Professor Thanh Phan said, "We should make every effort to implement the use of dual antiplatelet therapy within 24 hours in hospitals, as the current one of keeping patients "nil-by-mouth" (nothing to eat or drink) prevents patients from taking advantage of the new advances."
Reference:
Comparison of Dual Antiplatelet Therapies for Minor, Nondisabling, Acute Ischemic Stroke: A Bayesian Network Meta-Analysis Andy Lim, Henry Ma, John Ly, Shaloo Singhal, Yuesong Pan, Yongjun Wang, S Claiborne Johnston, Thanh G Phan DOI: 10.1001/jamanetworkopen.2024.11735.
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