James SK et al [Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes and a History of Stroke or Transient Ischemic Attack. Circulation. 2012; 125: 2914-2921] compared the effects of ticagrelor and clopidogrel in subjects with acute coronary syndrome and with or without prior history of ischemic stroke or TIA (transient ischemic attack) in the PLATelet inhibition and patient Outcomes (PLATO) trial. Those who had prior TIA or stroke were found to have higher rates of clinical outcomes like myocardial infarction, death, stroke and intracranial bleeding. The authors also concluded that the efficacy and bleeding risk of ticagrelor in these high risk patients were consistent with that of other patients in the trial, with favourable net clinical benefit.
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