Ticagrelor plus aspirin was associated with a lower risk for recurrent stroke than clopidogrel plus aspirin in patients with obesity who carry the CYP2C19 loss-of-function allele.
Gregory A. Maniatis, MD, director of structural heart disease at Northwell Staten Island University Hospital in New York City, said: "The best combination of antiplatelet agents for a given patient is an issue that cardiologists deal with regularly." He added that the authors' conclusions"seem valid for the population studied in the article." Maniatis was not involved in the current study.
That said, with a secondary analysis of a randomized controlled trial,"there is an increased risk of type I error [ie, false positive], and thus, the need for a greater sample size or setting a lower significance level to ensure statistical meaningfulness. A study that includes a more diverse population and longer-term follow-up would be desirable, he added. "In this study, the greatest benefit of ticagrelor–aspirin, compared to clopidogrel–aspirin, appeared to occur within the first 30 days of treatment, although the curves seem to continually diverge.
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