{"doi":"10.1056/nejmoa2111749","title":"Ticagrelor versus Clopidogrel in\n                    <i>CYP2C19</i>\n                    Loss-of-Function Carriers with Stroke or TIA","abstract":null,"journal":"New England Journal of Medicine","year":2021,"id":620358,"datarank":0.8941508009434912,"base_score":5.961005339623274,"endowment":5.961005339623274,"self_citation_contribution":0.8941508009434912,"citation_network_contribution":0.0,"self_endowment_contribution":0.8941508009434912,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":387,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":25,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1221478,"name":"Xia Meng","orcid":"0000-0002-4918-0845","position":1,"is_corresponding":false},{"id":1601448,"name":"Anxin Wang","orcid":null,"position":2,"is_corresponding":false},{"id":1601449,"name":"Xuewei Xie","orcid":null,"position":3,"is_corresponding":false},{"id":364204,"name":"Yuesong Pan","orcid":"0000-0003-3082-6789","position":4,"is_corresponding":false},{"id":558525,"name":"S. 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METHODS: loss-of-function alleles. Patients were assigned within 24 hours after symptom onset, in a 1:1 ratio, to receive ticagrelor (180 mg on day 1 followed by 90 mg twice daily on days 2 through 90) and placebo clopidogrel or to receive clopidogrel (300 mg on day 1 followed by 75 mg once daily on days 2 through 90) and placebo ticagrelor; both groups received aspirin for 21 days. The primary efficacy outcome was new stroke, and the primary safety outcome was severe or moderate bleeding, both within 90 days. RESULTS: A total of 11,255 patients were screened and 6412 patients were enrolled, with 3205 assigned to the ticagrelor group and 3207 to the clopidogrel group. The median age of the patients was 64.8 years, and 33.8% were women; 98.0% belonged to the Han Chinese ethnic group. Stroke occurred within 90 days in 191 patients (6.0%) in the ticagrelor group and 243 patients (7.6%) in the clopidogrel group (hazard ratio, 0.77; 95% confidence interval, 0.64 to 0.94; P = 0.008). Secondary outcomes were generally in the same direction as the primary outcome. Severe or moderate bleeding occurred in 9 patients (0.3%) in the ticagrelor group and in 11 patients (0.3%) in the clopidogrel group; any bleeding occurred in 170 patients (5.3%) and 80 patients (2.5%), respectively. CONCLUSIONS: loss-of-function alleles, the risk of stroke at 90 days was modestly lower with ticagrelor than with clopidogrel. The risk of severe or moderate bleeding did not differ between the two treatment groups, but ticagrelor was associated with more total bleeding events than clopidogrel. 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Management","Neutrophil, Myeloperoxidase and Oxidative Mechanisms","Aged","Aspirin","Clopidogrel","Cytochrome P-450 CYP2C19","Double-Blind Method","Drug Therapy, Combination","Female","Humans","Incidence","Ischemic Attack, Transient","Ischemic Stroke","Loss of Function Mutation","Male","Middle Aged","Platelet Aggregation Inhibitors","Purinergic P2Y Receptor Antagonists","Secondary Prevention","Ticagrelor"],"mesh_terms":["Loss of Function Mutation","Clopidogrel","Ticagrelor","Ischemic Stroke","Aged","Aspirin","Ischemic Attack, Transient","Double-Blind Method","Drug Therapy, Combination","Female","Humans","Male","Middle Aged","Platelet Aggregation Inhibitors","Incidence","Secondary Prevention","Purinergic P2Y Receptor Antagonists","Cytochrome P-450 CYP2C19"],"keywords":["Ticagrelor","Clopidogrel","CYP2C19","Medicine","Stroke (engine)","Internal medicine","Cardiology","Aspirin","Physics"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and 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