Clinical trial - DAPT

 Clinical trial - DAPT

Antiplatelet agents
Aspirin
- acetylation of COX-1
- onset of action after loading dose: 20 min
- time to platelet function recovery after drug cessation: 5-7 days

Clopidogrel
- irreversible P2Y12 antagonist
- onset of action after loading dose: 2-6 h
- time to platelet function recovery after drug cessation: 7 days

Ticagrelor
- reversible P2Y12 antagonist
- onset of action after loading dose: 30 min
- time to platelet function recovery after drug cessation 7-10 days

Clinical trials
Minor stroke or high-risk TIA

CHANCE (2013)
- DAPT (clopidogrel 300/75 & ASA) is superior to ASA monotherapy
- chinese population

POINT (2018)
- DAPT (clopidogrel 600/75 & ASA) is superior to ASA monotherapy
- non-chinese population

THALES (2020)
- DAPT (ticagrelor & ASA) is superior to ASA monotherapy

TARDIS (2017)
- triple therapy (clopidogrel & ASA & dipyridamole) causes too many bleedings

SOCRATES (2015)
- ticagrelor has the same benefit as ASA

INSPIRES (2023)
- DAPT (clopidogrel 300/75 & ASA) is superior to ASA monotherapy

Mild to moderate ischemic stroke
ATAMIS (2024)
- DAPT (clopidogrel 300/75 & ASA) is superior to ASA monotherapy

Minor non-disabling stroke
ARAMIS (2023)
- DAPT (clopidogrel 300/75 & ASA) same to tPA

ICAD
SAMMPRIS (2011)
- Medical therapy is superior to intra-cranial stenting