Low-dose ticagrelor combined with aspirin for preventing early neurological deterioration in patients with high-risk non-disabling ischemic cerebrovascular events: a multicenter, prospective, randomized, open-label, clinical trial.
J NeurolSep 7, 2026 (epub)
Jiahui Liu, Hua Cao, Mingli Wang et al.
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In 30 seconds
This multicenter, prospective, randomized trial evaluated the efficacy of low-dose ticagrelor (60 mg twice daily) plus aspirin versus clopidogrel plus aspirin in preventing early neurological deterioration (END) in 334 patients with high-risk non-disabling ischemic cerebrovascular events. The ticagrelor group had a significantly lower END incidence of 10.8% compared to 22.2% in the clopidogrel group (p=0.023).
Key findings
- The incidence of END within 7 days was 10.8% in the ticagrelor group versus 22.2% in the clopidogrel group (p=0.023).
- At 90 days, 92.8% of patients in the ticagrelor group achieved an excellent functional outcome compared to 80.8% in the clopidogrel group (p=0.002).
- Bleeding events were similar between groups, with 6.0% in the ticagrelor group and 4.2% in the clopidogrel group (p=0.563).
Why it matters
The findings suggest that low-dose ticagrelor combined with aspirin may be a more effective strategy for preventing early neurological deterioration in high-risk patients, potentially improving long-term functional outcomes without increasing bleeding risk.