Effect of insulin resistance on ticagrelor-versus clopidogrel-based dual antiplatelet therapy for secondary prevention of stroke in carriers of <i>CYP2C19</i> loss-of-function mutations.

ABSTRACT:

Background

Insulin resistance is associated with increased platelet reactivity. We sought to investigate the effects of insulin resistance on dual antiplatelet therapy in CYP2C19 loss-of-function carriers with minor stroke or transient ischemic attack (TIA).

Methods

We conducted a post hoc analysis of the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II (CHANCE-2) trial, in which we randomized patients with minor stroke or TIA who carried CYP2C19 loss-of-function mutations to receive ticagrelor-acetylsalicylic acid (ASA) or clopidogrel-ASA. We categorized patients by insulin resistance status using a cut-off of 8 mg/kg/min in the estimated glucose disposal rate. The primary efficacy outcome was recurrent stroke. The primary sa

SUBMITTER: Zhao J 

PROVIDER: S-EPMC12826683 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature