Comparing Ticagrelor and Cilostazol for Minor Ischemic Stroke or TIA

Ticagrelor Versus Cilostazol in Ischemic Stroke

This study is testing whether ticagrelor or cilostazol, along with aspirin, can help people who have had a minor stroke or a TIA feel better and recover more effectively.

Quick facts

• Phase: Phase 3
• Study type: Interventional
• Enrollment: 900 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: Kafrelsheikh University (Academic / other)
• Drugs / interventions: chemotherapy
• Locations: 1 site (Kafr ash Shaykh)
• Trial ID: NCT06196047 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the efficacy and safety of ticagrelor versus cilostazol in patients experiencing their first-ever minor ischemic stroke or transient ischemic attack (TIA). Conducted at Kafr Elsheikh University Hospital, the study involves 900 participants who will be randomized into two groups, receiving either ticagrelor or cilostazol along with aspirin. The trial will assess outcomes using the NIHSS and Modified Rankin Scale over a follow-up period of 90 days. Patients will undergo various clinical assessments and imaging to monitor their progress and any adverse effects.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18-75 experiencing their first-ever minor ischemic stroke or TIA who can receive antiplatelet treatment within the first 24 hours.

Not a fit: Patients with a known history of persistent CNS pathology, major organ failure, or those who have had recent myocardial infarction may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide a more effective treatment option for patients suffering from minor ischemic strokes or TIAs.

How similar studies have performed: While this approach is being tested in this specific context, similar studies have shown promise in evaluating antiplatelet therapies for stroke management.

Eligibility criteria

Inclusion Criteria:

* the investigators included both genders with eligible ages ranging between 18-75 years, with the first-ever presentation with acute minor ischemic stroke or TIA who received antiplatelet treatment within the first 24 hours of the onset of ischemic stroke. Patients are not eligible for rt-PA treatment

Exclusion Criteria:

* Exclusion Criteria: The investigators excluded patients who had not been followed up on for 90 days after enrollment, those with NIHSS \> 4, and patients with a known history of persistent or recurrent CNS pathology (e.g., epilepsy, meningioma, multiple sclerosis, history of head trauma with a residual neurological deficit).

We excluded patients who had clinical seizures at the onset of their stroke, as well as those who had symptoms of any major organ failure, active malignancies, or an acute myocardial infarction within the previous six weeks, and those who were on warfarin, regular ticagrelor during the week before admission, or chemotherapy within the previous year.

For safety measures and to avoid associated confounders, we excluded patients with active peptic ulcers, GIT surgery, bleeding history within the last year, and those with a history of major surgery within the last three months.

We ruled out of our trial patients who had a known allergy to the study drugs and those with INR \> 1.4 or P.T. \>18 or blood glucose level \< 50 or \> 400 mg/DL or blood pressure \< 90/60 or \> 185/110 mmHg on admission or Platelets \< 100,000.

The investigators considered pregnant and lactating patients or those with stroke due to venous thrombosis, those with wake-up stroke and stroke following cardiac arrest or profuse hypotension ineligible for our trial.

Where this trial is running

Kafr ash Shaykh

• Kafr Elsheikh University Hospital — Kafr ash Shaykh, Egypt (Recruiting)

Study contacts

• Study coordinator: mohamed G Zeinhom, MD

Conditions Ischemic Stroke; ticagrelor; acute ischemic stroke; cilostazol; Egypt