Does the overall conclusion of the CHANCE-2 trial make ticagrelor + ASA a worthwhile transition given the data showing cumulative hazard of stroke diverged during the first week and was subsequently similar, which suggests the benefit of ticagrelor over clopidogrel is seen predominantly soon after stroke?

Given the fact that clopidogrel costs 11 cents a day and ticagrelor costs almost $8/day and the fact that most patients will not be tested for slow CYP2c19 metabolizer (or have the results back in a timely fashion), it seems that the combination of ASA plus clopidogrel is the best option from a publ...

I think that ticagrelor plus aspirin is reasonable in slow CYP2c19 metabolizers if you test for it.

Both CHANCE (Wang et al., PMID 23803136) and POINT (Johnston et al., PMID 29766750) also found that most of the benefit of clopidogrel was in the first week of treatment, with continued benefit out to 21 days of treatment in post hoc analyses. THALES (Johnston et al., PMID 32668111) tested 30-day tr...

More data is needed to validate CHANCE-2 (Wang et al., PMID 34708996) findings.