Baseline characteristics according to homocysteine level and treatment
| Characteristic | Homocysteine ≤ 12.9 μmol/L n = 2650 | Homocysteine > 12.9 μmol/L n = 2790 | ||||
|---|---|---|---|---|---|---|
| No. (%) of patients* | p value | No. (%) of patients* | p value | |||
| Ticagrelor–ASA n = 1349 | Clopidogrel–ASA n = 1301 | Ticagrelor–ASA n = 1391 | Clopidogrel–ASA n = 1399 | |||
| Age, yr, median (IQR) | 63.6 (56.1–70.2) | 63.6 (56.2–69.7) | 0.7 | 65.9 (57.5–73.2) | 65.2 (56.9–72.3) | 0.04 |
| Sex, female | 594 (44.0) | 598 (46.0) | 0.3 | 326 (23.4) | 294 (21.0) | 0.1 |
| Ethnicity, Han | 1326 (98.3) | 1270 (97.6) | 0.2 | 1360 (97.8) | 1371 (98.0) | 0.7 |
| Blood pressure, mm Hg, median (IQR) | ||||||
| Systolic | 150 (137–161.5) | 148.5 (136–161) | 0.4 | 147 (136–162) | 148 (135.5–161) | 0.6 |
| Diastolic | 86 (80–94) | 86 (80–94) | 0.6 | 86 (80–95) | 86 (80–95) | 0.7 |
| Medical history | ||||||
| Hypertension | 833 (61.7) | 795 (61.1) | 0.7 | 862 (62.0) | 877 (62.7) | 0.7 |
| Diabetes mellitus | 409 (30.3) | 378 (29.1) | 0.5 | 278 (20.0) | 259 (18.5) | 0.3 |
| Dyslipidemia | 137 (10.2) | 132 (10.1) | > 0.9 | 144 (10.4) | 119 (8.5) | 0.1 |
| Previous ischemic stroke | 254 (18.8) | 276 (21.2) | 0.1 | 324 (23.3) | 319 (22.8) | 0.8 |
| Previous TIA | 19 (1.4) | 19 (1.5) | 0.9 | 19 (1.4) | 18 (1.3) | 0.8 |
| Myocardial infarction | 19 (1.4) | 24 (1.8) | 0.4 | 25 (1.8) | 13 (0.9) | 0.05 |
| Current smoking | 360 (26.7) | 316 (24.3) | 0.2 | 519 (37.3) | 532 (38.0) | 0.7 |
| CYP2C19 LOF allele carriers | ||||||
| Intermediate metabolizers | 1053 (78.1) | 1022 (78.6) | 0.8 | 1072 (77.1) | 1095 (78.3) | 0.4 |
| Poor metabolizers | 296 (21.9) | 279 (21.4) | 319 (22.9) | 304 (21.7) | ||
| Median time from symptom onset to randomization, h | ||||||
| < 12 | 554 (41.1) | 531 (40.8) | 0.9 | 560 (40.3) | 549 (39.2) | 0.6 |
| ≥ 12 | 795 (58.9) | 770 (59.2) | 831 (59.7) | 850 (60.8) | ||
| Qualifying event | ||||||
| Ischemic stroke | 1071 (79.4) | 1019 (78.3) | 0.5 | 1114 (80.1) | 1144 (81.8) | 0.3 |
| TIA | 278 (20.6) | 282 (21.7) | 277 (19.9) | 255 (18.2) | ||
| NIHSS score in patients with qualifying ischemic stroke, median (IQR)† | 2 (1–3) | 2 (1–3) | 0.5 | 2 (1–3) | 2 (1–3) | 0.5 |
| ABCD2 score in patients with qualifying TIA, median (IQR)‡ | 4 (4–5) | 4 (4–5) | 0.9 | 4 (4–5) | 5 (4–5) | > 0.9 |
| Previous antiplatelet therapy§ | 157 (11.6) | 157 (12.1) | 0.7 | 181 (13.0) | 162 (11.6) | 0.2 |
| Previous lipid-lowering therapy§ | 109 (8.1) | 107 (8.2) | 0.9 | 116 (8.3) | 103 (7.4) | 0.3 |
| Symptomatic ICAS | 517 (41.0) | 495 (41.3) | 0.9 | 520 (40.3) | 500 (38.6) | 0.4 |
| Symptomatic ECAS | 102 (8.1) | 87 (7.3) | 0.4 | 133 (10.3) | 123 (9.5) | 0.5 |
| eGFR, median (IQR), mL/min/1.73 m2 | 96.3 (87.7–104.1) | 95.8 (87.6–104.2) | 0.6 | 90.6 (78.0–99.8) | 91.6 (78.6–102.3) | 0.07 |
Note: ABCD2 = Age, Blood pressure, Clinical features, Duration of symptoms, Diabetes, ASA = acetylsalicylic acid, ECAS = extracranial artery stenosis, eGFR = estimated glomerular filtration rate, ICAS = intracranial artery stenosis, IQR = interquartile range, LOF = loss-of-function, NIHSS = National Institutes of Health Stroke Scale, TIA = transient ischemic attack.
↵* Unless stated otherwise.
↵† NIHSS scores range from 0 to 42, with higher scores indicating more severe stroke.
↵‡ ABCD2 score assesses the risk of stroke on the basis of age, blood pressure, clinical features, duration of TIA, and presence or absence of diabetes, with scores ranging from 0 to 7 and higher scores indicating greater risk.
↵§ Medication within 1 month before symptom onset.