Clopidogrel With Aspirin in High-risk Patients With Acute Non-disabling Cerebrovascular Events II

Exclusion Criteria

• •1. Malformation, tumor, abscess or other major non-ischemic brain disease (e.g., multiple sclerosis) on baseline head CT or MRI.
• •2. Isolated or pure sensory symptoms (e.g., numbness), isolated visual changes, or isolated dizziness/vertigo without evidence of acute infarction on baseline head CT or MRI.
• •3. Iatrogenic causes (angioplasty or surgery) of minor stroke or TIA.
• •4. Preceding moderate or severe dependency (modified Rankin scale \[mRS\] score 3-5).
• •5. Contraindication to clopidogrel, ticagrelor or aspirin
• •* Known allergy
• •* Severe renal (creatinine exceeding 1.5 times of the upper limit of normal range) or hepatic (ALT or AST \> twice the upper limit of normal range) insufficiency
• •* Severe cardiac failure (NYHA level: III to IV)
• •* History of hemostatic disorder or systemic bleeding
• •* History of thrombocytopenia or neutropenia
• •* History of drug-induced hematologic disorder or hepatic dysfunction
• •* Low white blood cell (\<2×109/L) or platelet count (\<100×109/L)
• •6. Hematocrit (HCT) \<30%
• •7. Clear indication for anticoagulation (presumed cardiac source of embolus, e.g., atrial fibrillation, prosthetic cardiac valves known or suspected endocarditis)
• •8. History of intracranial hemorrhage or amyloid angiopathy
• •9. History of aneurysm (including intracranial aneurysm and peripheral aneurysm)
• •10. History of asthma or COPD (chronic obstructive pulmonary disease)
• •11. High-risk for bradyarrhythmia (first-degree or second-degree AV block caused by sinus node disease, and brady-arrhythmic syncope without pacemaker)
• •12. History of hyperuricemia nephropathy
• •13. Anticipated requirement for long-term (\>7 days) non-steroidal anti-inflammatory drugs (NSAIDs)
• •14. Planned or likely revascularization (any angioplasty or vascular surgery) within the next 3 months
• •15. Scheduled for surgery or interventional treatment requiring study drug cessation
• •16. Severe non-cardiovascular comorbidity with life expectancy \< 3 months
• •17. Inability to understand and/or follow research procedures due to mental, cognitive, or emotional disorders
• •18. Dual antiplatelet treatment (or more than two antiplatelet agents) in 72 hours before randomization
• •19. Current treatment (last dose given within 10 days before randomization) with heparin therapy or oral anti coagulation
• •20. Intravenous thrombolytic therapy (such as intravenous rtPA) or mechanical thrombectomy within 24 hours prior to randomization
• •21. Gastrointestinal bleed within 3 months or major surgery within 30 days
• •22. Diagnosis or suspicious diagnosis of acute coronary syndrome
• •23. Participation in another clinical study with an experimental product during the last 30 days
• •24. Currently receiving an experimental drug or device
• •25. Pregnant, currently trying to become pregnant, or of child-bearing potential and not using birth control