---
title: "Low‑dose ticagrelor plus aspirin versus clopidogrel plus aspirin to prevent early neurological det"
id: "pubmed-42704480"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42704480"
content_type: "clinical_feed_article"
specialty: "Neurology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42704480/"
doi: "10.1007/s00415-026-14094-4"
published_at: "2026-09-07T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Low‑dose ticagrelor plus aspirin versus clopidogrel plus aspirin to prevent early neurological det
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42704480
- **Specialty:** [Neurology](https://medichelpline.com/clinical-feed/neurology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42704480/)
- **DOI:** [10.1007/s00415-026-14094-4](https://doi.org/10.1007%2Fs00415-026-14094-4)
- **Published At:** 2026-09-07T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This multicenter, prospective, randomized, open‑label, blinded‑endpoint clinical trial enrolled patients in China with **high‑risk non‑disabling ischemic cerebrovascular events (HR‑NICE)** within 24 hours of symptom onset. - The trial compared dual antiplatelet regimens: low‑dose **ticagrelor** (60 mg twice daily) plus **aspirin** (TA group) versus **clopidogrel** plus **aspirin** (LA group) in a 1:1 randomization. - The primary objective was prevention of **early neurological deterioration (END)** within 7 days. - Rationale: clopidogrel efficacy is substantially limited by **CYP2C19** genetic polymorphisms; ticagrelor provides an alternative P2Y12 inhibitor that does not require metabolic activation. - The trial was designed to assess whether low‑dose ticagrelor + aspirin is superior to clopidogrel + aspirin for preventing END without increasing bleeding risk. - The published PubMed record provides background, design, interventions, and the primary endpoint, but the abstract is truncated and does not include outcome data, numerical results, safety outcomes, sample size, statistical methods, or conclusions. - Details such as enrollment numbers, baseline characteristics, efficacy results for END, bleeding event rates, secondary endpoints, and authors’ conclusions were not reported in the accessible source abstract and therefore cannot be summarized here. - Because outcome and safety data are missing from the source abstract, interpretation of clinical impact, effect size, and applicability cannot be determined from the provided record alone.
## Clinical Analysis & Structured Key Points
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](https://pubmed.ncbi.nlm.nih.gov/42704480/#abstract) * [ Conflict of interest statement ](https://pubmed.ncbi.nlm.nih.gov/42704480/#conflict-of-interest) * [ References ](https://pubmed.ncbi.nlm.nih.gov/42704480/#references) * [ Publication types ](https://pubmed.ncbi.nlm.nih.gov/42704480/#publication-types) * [ MeSH terms ](https://pubmed.ncbi.nlm.nih.gov/42704480/#mesh-terms) * [ Substances ](https://pubmed.ncbi.nlm.nih.gov/42704480/#substances) * [ Grants and funding ](https://pubmed.ncbi.nlm.nih.gov/42704480/#grants) Title & authors Abstract Conflict of interest statement References Publication types MeSH terms Substances Grants and funding Randomized Controlled Trial J Neurol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Neurol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Neurol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42704480/) . 2026 Sep 7;273(10):568. doi: 10.1007/s00415-026-14094-4. # Low-dose ticagrelor combined with aspirin for preventing early neurological deterioration in patients with high-risk non-disabling ischemic cerebrovascular events: a multicenter, prospective, randomized, open-label, clinical trial [Jiahui Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+J&cauthor_id=42704480)[#](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Hua Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+H&cauthor_id=42704480)[#](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Mingli Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+M&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Yang Jiao](https://pubmed.ncbi.nlm.nih.gov/?term=Jiao+Y&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Ruijun Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+R&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Yihan Tang](https://pubmed.ncbi.nlm.nih.gov/?term=Tang+Y&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Rui Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+R&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Xiaoli Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+X&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Jingshun Shen](https://pubmed.ncbi.nlm.nih.gov/?term=Shen+J&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Dongyun Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+D&cauthor_id=42704480)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-2 "Department of Neurology, Dalian Lvshun District People's Hospital, Dalian, China."), [Wen Tian](https://pubmed.ncbi.nlm.nih.gov/?term=Tian+W&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Xing Gong](https://pubmed.ncbi.nlm.nih.gov/?term=Gong+X&cauthor_id=42704480)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-3 "Stem Cell Clinical Research Center, National Joint Engineering Laboratory, Regenerative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China."), [Bingwei Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+B&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Yong Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Y&cauthor_id=42704480)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-4 "Department of Rehabilitation Medicine, First Affiliated Hospital of Dalian Medical University, College of Health-Preservation and Wellness, Dalian Medical University, 5 Longjiang Road, Jinzhou District, Dalian, 116000, Liaoning, China. fuwa52008@126.com."), [Xiaofei Ji](https://pubmed.ncbi.nlm.nih.gov/?term=Ji+X&cauthor_id=42704480)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#full-view-affiliation-5 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China. jixiaofei1979@163.com.") Affiliations Expand ### Affiliations * 1 Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China. * 2 Department of Neurology, Dalian Lvshun District People's Hospital, Dalian, China. * 3 Stem Cell Clinical Research Center, National Joint Engineering Laboratory, Regenerative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China. * 4 Department of Rehabilitation Medicine, First Affiliated Hospital of Dalian Medical University, College of Health-Preservation and Wellness, Dalian Medical University, 5 Longjiang Road, Jinzhou District, Dalian, 116000, Liaoning, China. fuwa52008@126.com. * 5 Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China. jixiaofei1979@163.com. # Contributed equally. * PMID: **42704480** * DOI: [ 10.1007/s00415-026-14094-4 ](https://doi.org/10.1007/s00415-026-14094-4) Item in Clipboard Randomized Controlled Trial # Low-dose ticagrelor combined with aspirin for preventing early neurological deterioration in patients with high-risk non-disabling ischemic cerebrovascular events: a multicenter, prospective, randomized, open-label, clinical trial Jiahui Liu et al. J Neurol. 2026. Show details Display options Display options Format Abstract PubMed PMID J Neurol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Neurol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Neurol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42704480/) . 2026 Sep 7;273(10):568. doi: 10.1007/s00415-026-14094-4. ### Authors [Jiahui Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+J&cauthor_id=42704480)[#](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Hua Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+H&cauthor_id=42704480)[#](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Mingli Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+M&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Yang Jiao](https://pubmed.ncbi.nlm.nih.gov/?term=Jiao+Y&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Ruijun Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+R&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Yihan Tang](https://pubmed.ncbi.nlm.nih.gov/?term=Tang+Y&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Rui Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+R&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Xiaoli Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+X&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Jingshun Shen](https://pubmed.ncbi.nlm.nih.gov/?term=Shen+J&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Dongyun Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+D&cauthor_id=42704480)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-2 "Department of Neurology, Dalian Lvshun District People's Hospital, Dalian, China."), [Wen Tian](https://pubmed.ncbi.nlm.nih.gov/?term=Tian+W&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Xing Gong](https://pubmed.ncbi.nlm.nih.gov/?term=Gong+X&cauthor_id=42704480)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-3 "Stem Cell Clinical Research Center, National Joint Engineering Laboratory, Regenerative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China."), [Bingwei Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+B&cauthor_id=42704480)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-1 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China."), [Yong Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Y&cauthor_id=42704480)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-4 "Department of Rehabilitation Medicine, First Affiliated Hospital of Dalian Medical University, College of Health-Preservation and Wellness, Dalian Medical University, 5 Longjiang Road, Jinzhou District, Dalian, 116000, Liaoning, China. fuwa52008@126.com."), [Xiaofei Ji](https://pubmed.ncbi.nlm.nih.gov/?term=Ji+X&cauthor_id=42704480)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42704480/#short-view-affiliation-5 "Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China. jixiaofei1979@163.com.") ### Affiliations * 1 Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China. * 2 Department of Neurology, Dalian Lvshun District People's Hospital, Dalian, China. * 3 Stem Cell Clinical Research Center, National Joint Engineering Laboratory, Regenerative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China. * 4 Department of Rehabilitation Medicine, First Affiliated Hospital of Dalian Medical University, College of Health-Preservation and Wellness, Dalian Medical University, 5 Longjiang Road, Jinzhou District, Dalian, 116000, Liaoning, China. fuwa52008@126.com. * 5 Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, Liaoning, China. jixiaofei1979@163.com. # Contributed equally. * PMID: **42704480** * DOI: [ 10.1007/s00415-026-14094-4 ](https://doi.org/10.1007/s00415-026-14094-4) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Early neurological deterioration (END) is associated with a poor prognosis in patients with high‑risk non‑disabling ischemic cerebrovascular events (HR‑NICE). Clopidogrel-based dual antiplatelet therapy is substantially limited by the CYP2C19 gene polymorphism. This study aimed to investigate whether low‑dose ticagrelor (60 mg twice daily) plus aspirin dual antiplatelet therapy was superior to clopidogrel plus aspirin for preventing END within 7 days in HR-NICE patients, without increasing the bleeding risk. **Methods:** This was a multicenter, prospective, randomized, open-label, blinded-endpoint clinical trial conducted in China. Patients with HR‑NICE within 24 h of onset were enrolled. They were randomly assigned to receive low-dose ticagrelor (60 mg twice daily) plus aspirin (TA group) or clopidogrel plus aspirin (LA group) in a 1:1 ratio. The primary outcome was END with
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