Testing ticagrelor versus clopidogrel after acute ischemic stroke with clopidogrel resistance
Tests ticagrelor in adults with acute ischemic stroke and possible clopidogrel resistance.
Plain-language title generated from the registry record
Registry title: Precision Antiplatelet Therapy Guided by Platelet Aggregation Function in Patients With Acute Ischemic STROKE
Key facts
- Where
- Chengdu, ChinaSee the site
- Phase
- Phase 3
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with a mild acute ischaemic stroke or a high-risk TIA who show a weak response to clopidogrel on a platelet test.
- Age
- 18 years or older
- Sex
- Men and women can join.
- Disease stage
- Acute ischaemic stroke with NIHSS score ≤ 5, or TIA with ABCD₂ score ≥ 4. Symptoms began no more than 48 hours ago.
- Earlier treatment
- Must have received clopidogrel 300 mg and aspirin 100 mg together within 48 hours of symptom onset. Cannot have used other antiplatelet drugs (such as ticagrelor or prasugrel) within 7 days. Cannot have used heparin or oral anticoagulants within 10 days.
- Biomarker or test result
- MARADP ≥ 35%, measured 5-20 hours after taking clopidogrel 300 mg and aspirin 100 mg together.
Main reasons for not taking part
- Bleeding in the brain or other brain diseases seen on imaging
- Atrial fibrillation or other reasons to need blood-thinning (anticoagulant) treatment
- Clot-busting treatment or thrombectomy, or a plan to have it within 90 days
- Past stomach or gut bleeding, brain bleeding, or a bleeding disorder
- Severe heart, lung, liver or kidney problems, or pregnancy or breastfeeding
Read by machine on 9 November 2026.
Where in China
- Sichuan Provincial People's HospitalChengdu, ChinaContact: Jie Yang Deputy Director of the Department of NeurologyTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- Sichuan Provincial People's Hospital
- Trial code
- NCT06853535
- Record updated
- 12 May 2026
- Original description
The objective of this clinical trial is to evaluate the efficacy and safety of platelet aggregation function - guided precision anti - platelet therapy in patients with acute cerebral infarction. The main question it aims to answer is: among the cerebral infarction patients with possible clopidogrel resistance detected by platelet aggregation function tests, what is the efficacy and safety of using ticagrelor to replace the clopidogrel treatment regimen.Read full original descriptionShow less
Precision Antiplatelet Therapy Guided by Platelet Aggregation Function in Patients With Acute Ischemic STROKE
The objective of this clinical trial is to evaluate the efficacy and safety of platelet aggregation function - guided precision anti - platelet therapy in patients with acute cerebral infarction. The main question it aims to answer is: among the cerebral infarction patients with possible clopidogrel resistance detected by platelet aggregation function tests, what is the efficacy and safety of using ticagrelor to replace the clopidogrel treatment regimen.
Inclusion: Age ≥ 18 years old; Patients diagnosed with acute non-disabling ischaemic stroke or transient ischaemic attack (TIA) with moderate to high stroke risk in accordance with the WHO diagnostic criteria, defined as follows:; Acute non-disabling ischaemic stroke: NIHSS score ≤ 5 at enrollment; TIA with moderate to high stroke risk: ABCD₂ score ≥ 4; Time from symptom onset ≤ 48 hours. (Definition of symptom onset time: the interval from the last time the patient was observed in a normal state to the time of co-administration of clopidogrel 300 mg and aspirin 100 mg.); MARADP ≥ 35% measured at 5-20 hours after the patient received antiplatelet therapy with co-administration of clopidogrel 300 mg and aspirin 100 mg within 48 hours of symptom onset; Written informed consent signed by the patient or their legal representative.
Exclusion: Patients who have received intravenous thrombolysis, intra-arterial thrombolysis, mechanical thrombectomy, or any revascularization surgery after the current onset, or plan to receive such procedures within 90 days; Use of heparin or oral anticoagulants within 10 days prior to enrollment; Imaging examinations suggestive of hemorrhagic stroke, hemorrhagic transformation, or other pathological cerebral disorders, such as vascular malformation, tumor, abscess, or other common non-ischemic cerebral diseases (e.g., multiple sclerosis); Minor stroke/TIA induced by angioplasty or vascular surgery; Routine electrocardiogram (ECG) suggestive of atrial fibrillation (AF), or physical examination findings of typical AF signs including completely irregular cardiac rhythm, variable intensity of the first heart sound, and pulse deficit; Having definite indications for anticoagulant therapy (suspected cardiogenic embolism, e.g., atrial fibrillation, known artificial heart valve, suspected endocarditis, etc.); History of gastrointestinal bleeding, intracranial hemorrhage, massive hemorrhage or blood transfusion in the recent period (excluding mild hemoptysis and mild abnormal vaginal bleeding), or history of other hemorrhagic diseases caused by coagulation dysfunction (e.g., purpura); Patients with severe cardiac, pulmonary, hepatic, or renal insufficiency, and those with severe comorbidities (e.g., malignancy, chronic airflow limitation, severe dementia, severe heart failure); Having contraindications to or intolerance of clopidogrel, ticagrelor, or aspirin, including:; Known history of hypersensitivity; Severe hepatic or renal insufficiency (definition of severe hepatic insufficiency: ALT > 2× upper limit of normal [ULN] or AST > 2× ULN; definition of severe renal insufficiency: creatinine > 1.5× ULN); Severe heart failure (NYHA Class Ⅲ or Ⅳ); Coagulation disorders or history of systemic hemorrhage; History of previous thrombocytopenia or neutropenia; History of previous drug-induced hematological diseases or hepatic dysfunction; Leukopenia (< 2×10⁹/L) or thrombocytopenia (< 100×10⁹/L); Women of childbearing age with a negative pregnancy test but who refuse to adopt effective contraceptive measures; pregnant or lactating women; Use of antiplatelet agents other than aspirin and clopidogrel (e.g., ticagrelor, prasugrel) within 7 days; Poor compliance, unable to cooperate with the requirements of the study.