Significantly lower rate of stroke within 90 days seen for ticagrelor-ASA versus clopidogrel-ASA for those carrying CYP2C19<\/em> loss-of-function allele<\/p>\n<\/h3>\n By Elana Gotkine HealthDay Reporter<\/b><\/p>\n <\/b><\/p>\n MONDAY, July 10, 2023 (HealthDay News) — For patients with minor stroke or transient ischemic attack (TIA) who carry the CYP2C19<\/em> loss-of-function allele, those with obesity receive more clinical benefit from ticagrelor-acetylsalicylic acid (ASA) than clopidogrel-ASA, according to a study published online July 10 in CMAJ<\/em>, the journal of the Canadian Medical Association.<\/p>\n Jia Zhang, M.D., from The China National Clinical Research Center for Neurological Diseases in Beijing, and colleagues conducted a randomized, double-blind trial involving patients with minor stroke or TIA who carried the CYP2C19<\/em> loss-of-function allele. Participants were randomly assigned to receive ticagrelor-ASA or clopidogrel-ASA. Data were included for 6,412 patients: 876 were classified as obese and 5,536 were classified as nonobese.<\/p>\n The researchers found that among patients with obesity, ticagrelor-ASA was associated with a significantly lower rate of stroke within 90 days compared with clopidogrel-ASA (5.4 versus 11.3 percent; hazard ratio, 0.51; 95 percent confidence interval, 0.30 to 0.87), but not among those without obesity (6.0 versus 7.0 percent; hazard ratio, 0.84; 95 percent confidence interval, 0.69 to 1.04). No differences were seen in the rates of severe or moderate bleeding by body mass index group.<\/p>\n “Body mass index influences the efficacy of ticagrelor-ASA versus clopidogrel-ASA among patients with minor ischemic stroke or TIA who carry a CYP2C19<\/em> loss-of-function allele,” the authors write. “Clopidogrel appears to lose its efficacy among patients with obesity.”<\/p>\n