Official Title: Ticagrelor Versus Cilostazol in Moderate and Moderate-to-severe Ischemic Stroke a Randomized Controlled Trial
Status: RECRUITING
Status Verified Date: 2024-08
Last Known Status: None
Delayed Posting: No
If Stopped, Why?: Not Stopped
Has Expanded Access: No
If Expanded Access, NCT#: N/A
Has Expanded Access, NCT# Status: N/A
Acronym: None
Brief Summary: Along with the current clinical trial the efficacy and safety of a 180 mg loading dose of ticagrelor administered within 24 hours of the first-ever moderate and moderate to severe ischemic stroke compared to 200 mg cilostazol were assessed through NIHSS mRS and possible adverse effects
Detailed Description: The investigators conducted a single-blinded randomized controlled trial after the ethics committee of the faculty of medicine at Kafr el-Sheik University approved it
The investigators got written informed consent from all eligible patients or their first order of kin before randomization
The study will be composed of 2 arms ticagrelor arm which consisted of 450 patients who received a 180mg loading dose followed by 90 mg twice daily from the 2nd to the 90th day and the cilostazol arm consisting of 450 patients who received a 200 mg loading dose during the first 24 hours of stroke onset followed by 100 mg twice daily from the 2nd day to the 90th day
Study Procedures
Every patient in our study will undergo
clinical workup History clinical assessment NIHSS were recorded on admission day 7 and the Modified Rankin Scale as a follow-up after one week and 3 months
Detection of Risk Factors Profiles
Echocardiography TTE in indicated patients ECG Monitoring daily ECG monitoring will be performed in indicated patients 3- Carotid Duplex carotid duplex in indicated patients
4- ESR Lipid Profile liver functions All will be tested routinely for all patients
Imaging Follow-UP Non-contrast CT brain on admission Day 2 MRI after 2 days of admission all the patients in this study will have a brain MRI stroke protocol T1W T2W FLAIR DWI T2 Echo Gradient MRA of all intra-cerebral vessels
CT brain Any patient with unexplained clinical deterioration at any time throughout hisher hospital stay will be urgently imaged by CT
Primary End Point
The primary efficacy outcome was the rate of new stroke at 90 days and the primary safety outcome was the rate of drug hemorrhagic complications using the PLATO bleeding definition
Secondary End Point The secondary efficacy outcomes were to evaluate the rates of patients who achieved a significant reduction in NIHSS decrease of four points or more at the seventh day or discharge compared to baseline the rates of a favorable outcome with mRS 0-2 after one week and after 90 days in a face-to-face interview in the outpatient clinic rates of a composite of recurrent stroke myocardial infarction and death due to vascular events after 90 days of follow-up while the secondary safety outcome was the rate of treatment-related adverse effects assessed by a follow-up questionnaire