search
Back to results

Clopidogrel in High-risk Patients With Acute Non-disabling Cerebrovascular Events (CHANCE)

Primary Purpose

Stroke, Transient Ischemic Attack

Status
Completed
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Clopidogrel
Placebo of clopidogrel and Asprin
Sponsored by
Beijing Tiantan Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Stroke focused on measuring stroke, transient ischemic attack, acute treatment, acute non-disabling cerebrovascular event, clopidogrel, clopidogrel combined with ASA, recurrence of stroke and other vascular events

Eligibility Criteria

40 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  • Adult subjects (male or female≥40 years)
  • Acute non-disabling ischemic stroke (NIHSS≤3 at the time of randomization) that can be treated with study drug within 24 hours of symptoms onset. Symptom onset is defined by the "last see normal" principle
  • TIA (Neurological deficit attributed to focal brain ischemia, with resolution of the deficit within 24 hours of symptom onset), that can be treated with study drug within 24 hours of symptoms onset and with moderate-to-high risk of stroke recurrence (ABCD2 score≥4 at the time of randomization).Symptom onset is defined by the "last see normal" principle
  • Informed consent signed

Exclusion Criteria:

  • Diagnosis of hemorrhage or other pathology, such as vascular malformation, tumor, abscess or other major non-ischemic brain disease (e.g., multiple sclerosis) on baseline head CT or MRI
  • Isolated or pure sensory symptoms (e.g., numbness), isolated visual changes, or isolated dizziness/vertigo without evidence of acute infarction on baseline head CT or MRI
  • Modified Rankin Scale Score>2 at randomization (pre-morbid historical assessment)
  • NIH Stroke Score≥4 at randomization
  • Clear indication for anticoagulation(presumed cardiac source of embolus, e.g., atrial fibrillation, prosthetic cardiac valves known or suspected endocarditis)
  • Contraindication to clopidogrel or ASA
  • Known allergy
  • Severe renal or hepatic insufficiency
  • Severe cardiac failure, asthma
  • Hemostatic disorder or systemic bleeding
  • History of hemostatic disorder or systemic bleeding
  • History of thrombocytopenia or neutropenia
  • History of drug-induced hematologic or hepatic abnormalities
  • Low white blood cell (<2 x109/l) or platelet count (<100 x109/l)
  • Use of thrombolysis within 24 hours prior to randomization
  • History of intracranial hemorrhage
  • Anticipated requirement for long-term non-study antiplatelet drugs, or NSAIDs affecting platelet function
  • Current treatment (last dose given within 10 days before randomization) with heparin therapy or oral anti coagulation
  • Gastrointestinal bleed or major surgery within 3 months
  • Planned or likely revascularization (any angioplasty or vascular surgery) within the next 3 months (if clinically indicated, vascular imaging should be performed prior to randomization whenever possible)
  • Scheduled for surgery or interventional treatment requiring study drug cessation
  • Qualifying TIA or minor stroke induced by angiography or surgery
  • Severe non-cardiovascular comorbidity with life expectancy < 3 months
  • Women of childbearing age not practicing reliable contraception who do not have a documented negative pregnancy test
  • Currently receiving an investigational drug or device

Sites / Locations

  • Beijing Tian Tan Hospital, Capital Medical University

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Combination Clopidogrel and asprin

Asprin and placebo

Arm Description

Outcomes

Primary Outcome Measures

Percentage of patients with the 3-month new vascular events, defined as any event of the following: Any stroke (ischemic or hemorrhage)

Secondary Outcome Measures

Percentage of patients with the 3-month new clinical vascular events (ischemic stroke/ hemorrhagic stroke/ TIA/ MI/ vascular death) as a cluster and evaluated individually.
Modified Rankin Scale score changes (continuous) and dichotomized at percentage with score 0-2 vs. 3-6 at 3 month follow-up
Further efficacy exploratory analysis:Impairment (changes in NIHSS scores at 3 month follow-up).
Further efficacy exploratory analysis:Quality of Life (EuroQol EQ-5D scale)
Efficacy endpoint will also be analyzed stratified by etiological subtypes, by time randomization (< 12 hours vs. ≥ 12 hours), by qualifying event (TIA vs. minor stroke), and by age
Severe bleeding incidence (GUSTO definition), including fatal bleeding and symptomatic intracranial hemorrhage.
Incidence symptomatic and asymptomatic intracranial hemorrhagic events at 3 months
Intracranial hemorrhage
Total mortality

Full Information

First Posted
September 17, 2009
Last Updated
July 13, 2020
Sponsor
Beijing Tiantan Hospital
Collaborators
University of California, San Francisco
search

1. Study Identification

Unique Protocol Identification Number
NCT00979589
Brief Title
Clopidogrel in High-risk Patients With Acute Non-disabling Cerebrovascular Events
Acronym
CHANCE
Official Title
Randomized,Double-blind Trial Comparing the Effects of a 3-month Clopidogrel Regimen,Combined With ASA During the First 21days,Versus ASA Alone for the Acute Treatment of TIA or Minor Stroke
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Completed
Study Start Date
December 2009 (undefined)
Primary Completion Date
March 2012 (Actual)
Study Completion Date
June 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Beijing Tiantan Hospital
Collaborators
University of California, San Francisco

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the effects of a 3-month regimen of clopidogrel initiated with a loading dose (LD) of 300 mg followed by 75 mg/day during the first 21days versus a 3-month regimen of ASA 75 mg/day alone on reducing the 3-month risk of any stroke (both ischemic and hemorrhagic, primary outcome) when initiated within 24 hours of symptom onset in high-risk patients with TIA or minor stroke.
Detailed Description
Inclusion criteria: Adult subjects (male or female ≥ 40 years) Acute non-disabling ischemic stroke (NIHSS≤3 at the time of randomization) that can be treated with study drug within 24 hours of symptoms onset. Symptom onset is defined by the "last see normal" principle. TIA (Neurological deficit attributed to focal brain ischemia, with resolution of the deficit within 24 hours of symptom onset), that can be treated with study drug within 24 hours of symptoms onset and with moderate-to-high risk of stroke recurrence (ABCD2 score ≥ 4 at the time of randomization). Symptom onset is defined by the "last see normal" principle. Informed consent signed Primary Efficacy Endpoint: Percentage of patients with the 3-month new vascular events, defined as any event of the following:Any stroke (ischemic or hemorrhage).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stroke, Transient Ischemic Attack
Keywords
stroke, transient ischemic attack, acute treatment, acute non-disabling cerebrovascular event, clopidogrel, clopidogrel combined with ASA, recurrence of stroke and other vascular events

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
5100 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Combination Clopidogrel and asprin
Arm Type
Active Comparator
Arm Title
Asprin and placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Clopidogrel
Other Intervention Name(s)
Plavix
Intervention Description
The first group will receive a 300mg loading dose (LD) of clopidogrel on the day of randomization, followed by 75 mg clopidogrel/day from Day 2 to 3 months. ASA will be given in a total dose ranging between 75 mg and 300 mg (open label) on the first day, followed by blinded 75 mg once /day from Day 2 to Day 21st. Between Day 21st and 3-month visits, ASA 75 mg will be replaced by a placebo of ASA 75 mg.
Intervention Type
Drug
Intervention Name(s)
Placebo of clopidogrel and Asprin
Other Intervention Name(s)
Acetylsalicylic acid
Intervention Description
The second group will receive open label ASA in a total dose ranging between 75 mg and 300 mg on the first day, followed by blinded 75 mg once /day from Day 2 to 3 months. A placebo for clopidogrel will be given from the day of randomization until the 3-month visit.
Primary Outcome Measure Information:
Title
Percentage of patients with the 3-month new vascular events, defined as any event of the following: Any stroke (ischemic or hemorrhage)
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Percentage of patients with the 3-month new clinical vascular events (ischemic stroke/ hemorrhagic stroke/ TIA/ MI/ vascular death) as a cluster and evaluated individually.
Time Frame
3 months
Title
Modified Rankin Scale score changes (continuous) and dichotomized at percentage with score 0-2 vs. 3-6 at 3 month follow-up
Time Frame
3 months
Title
Further efficacy exploratory analysis:Impairment (changes in NIHSS scores at 3 month follow-up).
Time Frame
3 months
Title
Further efficacy exploratory analysis:Quality of Life (EuroQol EQ-5D scale)
Time Frame
3 months
Title
Efficacy endpoint will also be analyzed stratified by etiological subtypes, by time randomization (< 12 hours vs. ≥ 12 hours), by qualifying event (TIA vs. minor stroke), and by age
Time Frame
3 months
Title
Severe bleeding incidence (GUSTO definition), including fatal bleeding and symptomatic intracranial hemorrhage.
Time Frame
3 months
Title
Incidence symptomatic and asymptomatic intracranial hemorrhagic events at 3 months
Time Frame
3 months
Title
Intracranial hemorrhage
Time Frame
3 months
Title
Total mortality
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Adult subjects (male or female≥40 years) Acute non-disabling ischemic stroke (NIHSS≤3 at the time of randomization) that can be treated with study drug within 24 hours of symptoms onset. Symptom onset is defined by the "last see normal" principle TIA (Neurological deficit attributed to focal brain ischemia, with resolution of the deficit within 24 hours of symptom onset), that can be treated with study drug within 24 hours of symptoms onset and with moderate-to-high risk of stroke recurrence (ABCD2 score≥4 at the time of randomization).Symptom onset is defined by the "last see normal" principle Informed consent signed Exclusion Criteria: Diagnosis of hemorrhage or other pathology, such as vascular malformation, tumor, abscess or other major non-ischemic brain disease (e.g., multiple sclerosis) on baseline head CT or MRI Isolated or pure sensory symptoms (e.g., numbness), isolated visual changes, or isolated dizziness/vertigo without evidence of acute infarction on baseline head CT or MRI Modified Rankin Scale Score>2 at randomization (pre-morbid historical assessment) NIH Stroke Score≥4 at randomization Clear indication for anticoagulation(presumed cardiac source of embolus, e.g., atrial fibrillation, prosthetic cardiac valves known or suspected endocarditis) Contraindication to clopidogrel or ASA Known allergy Severe renal or hepatic insufficiency Severe cardiac failure, asthma Hemostatic disorder or systemic bleeding History of hemostatic disorder or systemic bleeding History of thrombocytopenia or neutropenia History of drug-induced hematologic or hepatic abnormalities Low white blood cell (<2 x109/l) or platelet count (<100 x109/l) Use of thrombolysis within 24 hours prior to randomization History of intracranial hemorrhage Anticipated requirement for long-term non-study antiplatelet drugs, or NSAIDs affecting platelet function Current treatment (last dose given within 10 days before randomization) with heparin therapy or oral anti coagulation Gastrointestinal bleed or major surgery within 3 months Planned or likely revascularization (any angioplasty or vascular surgery) within the next 3 months (if clinically indicated, vascular imaging should be performed prior to randomization whenever possible) Scheduled for surgery or interventional treatment requiring study drug cessation Qualifying TIA or minor stroke induced by angiography or surgery Severe non-cardiovascular comorbidity with life expectancy < 3 months Women of childbearing age not practicing reliable contraception who do not have a documented negative pregnancy test Currently receiving an investigational drug or device
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yongjun NA Wang, M.D
Organizational Affiliation
Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
S.Claiborne NA Johnston, M.D, Ph.D
Organizational Affiliation
Departments of Neurology, Epidemiology, University of California, San Francisco, USA
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Tian Tan Hospital, Capital Medical University
City
Beijing
ZIP/Postal Code
100050
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
20826243
Citation
Wang Y, Johnston SC; CHANCE Investigators. Rationale and design of a randomized, double-blind trial comparing the effects of a 3-month clopidogrel-aspirin regimen versus aspirin alone for the treatment of high-risk patients with acute nondisabling cerebrovascular event. Am Heart J. 2010 Sep;160(3):380-386.e1. doi: 10.1016/j.ahj.2010.05.017.
Results Reference
background
PubMed Identifier
27348249
Citation
Wang Y, Zhao X, Lin J, Li H, Johnston SC, Lin Y, Pan Y, Liu L, Wang D, Wang C, Meng X, Xu J, Wang Y; CHANCE investigators. Association Between CYP2C19 Loss-of-Function Allele Status and Efficacy of Clopidogrel for Risk Reduction Among Patients With Minor Stroke or Transient Ischemic Attack. JAMA. 2016 Jul 5;316(1):70-8. doi: 10.1001/jama.2016.8662.
Results Reference
background
PubMed Identifier
29582084
Citation
Jing J, Meng X, Zhao X, Liu L, Wang A, Pan Y, Li H, Wang D, Johnston SC, Wang Y, Wang Y. Dual Antiplatelet Therapy in Transient Ischemic Attack and Minor Stroke With Different Infarction Patterns: Subgroup Analysis of the CHANCE Randomized Clinical Trial. JAMA Neurol. 2018 Jun 1;75(6):711-719. doi: 10.1001/jamaneurol.2018.0247.
Results Reference
background
PubMed Identifier
31424481
Citation
Pan Y, Elm JJ, Li H, Easton JD, Wang Y, Farrant M, Meng X, Kim AS, Zhao X, Meurer WJ, Liu L, Dietrich D, Wang Y, Johnston SC. Outcomes Associated With Clopidogrel-Aspirin Use in Minor Stroke or Transient Ischemic Attack: A Pooled Analysis of Clopidogrel in High-Risk Patients With Acute Non-Disabling Cerebrovascular Events (CHANCE) and Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trials. JAMA Neurol. 2019 Dec 1;76(12):1466-1473. doi: 10.1001/jamaneurol.2019.2531. Erratum In: JAMA Neurol. 2019 Sep 30;: JAMA Neurol. 2021 Aug 16;:null.
Results Reference
background
PubMed Identifier
28202699
Citation
Pan Y, Meng X, Jing J, Li H, Zhao X, Liu L, Wang D, Johnston SC, Wang Y, Wang Y; CHANCE Investigators. Association of multiple infarctions and ICAS with outcomes of minor stroke and TIA. Neurology. 2017 Mar 14;88(11):1081-1088. doi: 10.1212/WNL.0000000000003719. Epub 2017 Feb 15.
Results Reference
background
PubMed Identifier
28424269
Citation
Pan Y, Jing J, Chen W, Meng X, Li H, Zhao X, Liu L, Wang D, Johnston SC, Wang Y, Wang Y; CHANCE investigators. Risks and benefits of clopidogrel-aspirin in minor stroke or TIA: Time course analysis of CHANCE. Neurology. 2017 May 16;88(20):1906-1911. doi: 10.1212/WNL.0000000000003941. Epub 2017 Apr 19. Erratum In: Neurology. 2019 Aug 13;93(7):322.
Results Reference
background
PubMed Identifier
29330312
Citation
Li J, Wang A, Zhao X, Liu L, Meng X, Lin J, Jing J, Zou X, Wang Y, Wang Y; CHANCE Investigators. High-sensitive C-reactive protein and dual antiplatelet in intracranial arterial stenosis. Neurology. 2018 Feb 6;90(6):e447-e454. doi: 10.1212/WNL.0000000000004928. Epub 2018 Jan 12.
Results Reference
background
PubMed Identifier
23803136
Citation
Wang Y, Wang Y, Zhao X, Liu L, Wang D, Wang C, Wang C, Li H, Meng X, Cui L, Jia J, Dong Q, Xu A, Zeng J, Li Y, Wang Z, Xia H, Johnston SC; CHANCE Investigators. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med. 2013 Jul 4;369(1):11-9. doi: 10.1056/NEJMoa1215340. Epub 2013 Jun 26.
Results Reference
result
PubMed Identifier
35959564
Citation
Chen P, Wu Q, Xie X, Jing J, Gu H, Wang X, Meng X, Liu L, Wang Y, Wang Y; CHANCE Investigators. Systolic blood pressure and recurrent stroke in patients with different lesion patterns on diffusion weighted imaging. J Clin Hypertens (Greenwich). 2022 Oct;24(10):1350-1357. doi: 10.1111/jch.14543. Epub 2022 Aug 12.
Results Reference
derived
PubMed Identifier
35695332
Citation
Zhang X, Jing J, Zhao X, Liu L, Wang A, Pan Y, Wang D, Johnston SC, Wang Y, Wang Y, Meng X. No rebound effect after a course of clopidogrel in patients with acute TIA or minor stroke. Neurol Res. 2022 Nov;44(11):957-963. doi: 10.1080/01616412.2022.2075660. Epub 2022 Jun 13.
Results Reference
derived
PubMed Identifier
35256525
Citation
Pan Y, Wangqin R, Li H, Jin A, Li J, Lin J, Meng X, Xian Y, Laskowitz DT, Wang Y. LDL-C levels, lipid-lowering treatment and recurrent stroke in minor ischaemic stroke or TIA. Stroke Vasc Neurol. 2022 Aug;7(4):276-284. doi: 10.1136/svn-2021-001317. Epub 2022 Mar 7.
Results Reference
derived
PubMed Identifier
35224730
Citation
Natale P, Palmer SC, Saglimbene VM, Ruospo M, Razavian M, Craig JC, Jardine MJ, Webster AC, Strippoli GF. Antiplatelet agents for chronic kidney disease. Cochrane Database Syst Rev. 2022 Feb 28;2(2):CD008834. doi: 10.1002/14651858.CD008834.pub4.
Results Reference
derived
PubMed Identifier
33093222
Citation
Pan Y, Wangqin R, Li H, Wang Y, Meng X, Johnston SC, Simon T, Lin J, Zhao X, Liu L, Wang D, Wang Y. F2R Polymorphisms and Clopidogrel Efficacy and Safety in Patients With Minor Stroke or TIA. Neurology. 2021 Jan 5;96(1):e1-e9. doi: 10.1212/WNL.0000000000011078. Epub 2020 Oct 22.
Results Reference
derived
PubMed Identifier
32958697
Citation
Wang G, Jing J, Li J, Pan Y, Yan H, Meng X, Zhao X, Liu L, Li H, Wang DZ, Wang Y, Wang Y. Association of elevated hs-CRP and multiple infarctions with outcomes of minor stroke or TIA: subgroup analysis of CHANCE randomised clinical trial. Stroke Vasc Neurol. 2021 Mar;6(1):80-86. doi: 10.1136/svn-2020-000369. Epub 2020 Sep 21.
Results Reference
derived
PubMed Identifier
32606085
Citation
Chen H, Pan Y, Zong L, Jing J, Meng X, Xu Y, Yan H, Zhao X, Liu L, Li H, Johnston SC, Wang Y, Wang Y. Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes. Stroke Vasc Neurol. 2020 Jun;5(2):128-137. doi: 10.1136/svn-2019-000305. Epub 2020 Apr 15.
Results Reference
derived
PubMed Identifier
32355775
Citation
Xu YY, Zong LX, Zhang CQ, Pan YS, Jing J, Meng X, Li H, Zhao XQ, Liu LP, Wang D, Wang YL, Wang YJ; CHANCE Investigators. The association of white matter hyperintensities with stroke outcomes and antiplatelet therapy in minor stroke patients. Ann Transl Med. 2020 Mar;8(6):331. doi: 10.21037/atm.2020.02.137.
Results Reference
derived
PubMed Identifier
31941381
Citation
Li J, Wang Y, Li H, Zuo Z, Lin J, Wang A, Zhao X, Liu L, Wang Y; CHANCE Investigators. Homocysteine Level Predicts Response to Dual Antiplatelet in Women With Minor Stroke or Transient Ischemic Attack: Subanalysis of the CHANCE Trial. Arterioscler Thromb Vasc Biol. 2020 Mar;40(3):839-846. doi: 10.1161/ATVBAHA.119.313741. Epub 2020 Jan 16.
Results Reference
derived
PubMed Identifier
31822574
Citation
Yang M, Wang A, Li J, Zhao X, Liu L, Meng X, Jing J, Zhang N, Johnston SC, Wang Y, Wang Y. Lp-PLA2 and dual antiplatelet agents in intracranial arterial stenosis. Neurology. 2020 Jan 14;94(2):e181-e189. doi: 10.1212/WNL.0000000000008733. Epub 2019 Dec 10.
Results Reference
derived
PubMed Identifier
31726963
Citation
Mo J, Chen Z, Xu J, Wang A, Dai L, Cheng A, Meng X, Li H, Wang Y; CHANCE Investigators. Efficacy of Clopidogrel-Aspirin Therapy for Stroke Does Not Exist in CYP2C19 Loss-of-Function Allele Noncarriers With Overweight/Obesity. Stroke. 2020 Jan;51(1):224-231. doi: 10.1161/STROKEAHA.119.026845. Epub 2019 Nov 15.
Results Reference
derived
PubMed Identifier
31127478
Citation
Chen W, Pan Y, Jing J, Zhao X, Liu L, Meng X, Wang Y, Lin Y, Wang Y; CHANCE Investigators. Association of Body Mass Index and Risk of Stroke After Acute Minor Stroke or TIA: a Post Hoc Analysis of a Randomized Controlled Trial. Neurotox Res. 2019 Nov;36(4):836-843. doi: 10.1007/s12640-019-00056-4. Epub 2019 May 24.
Results Reference
derived
PubMed Identifier
30972875
Citation
Xie X, Wang X, Laskowitz DT, Zhao X, Miao Z, Liu L, Li H, Meng X, Wang Y, Wang Y; CHANCE investigators. Effect of dual versus mono antiplatelet therapy on recurrent stroke modulated by activated partial thromboplastin time. Eur J Neurol. 2019 Sep;26(9):1168-e78. doi: 10.1111/ene.13961. Epub 2019 May 9.
Results Reference
derived
PubMed Identifier
30742211
Citation
Pan Y, Chen W, Wang Y, Li H, Johnston SC, Simon T, Zhao X, Liu L, Wang D, Meng X, Wang Y; Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) Investigators. Association Between ABCB1 Polymorphisms and Outcomes of Clopidogrel Treatment in Patients With Minor Stroke or Transient Ischemic Attack: Secondary Analysis of a Randomized Clinical Trial. JAMA Neurol. 2019 May 1;76(5):552-560. doi: 10.1001/jamaneurol.2018.4775.
Results Reference
derived
PubMed Identifier
30621613
Citation
Wang G, Jing J, Pan Y, Meng X, Zhao X, Liu L, Li H, Wang D, Wang Y, Wang Y; CHANCE Investigatores. Does all single infarction have lower risk of stroke recurrence than multiple infarctions in minor stroke? BMC Neurol. 2019 Jan 8;19(1):7. doi: 10.1186/s12883-018-1215-0.
Results Reference
derived
PubMed Identifier
30355199
Citation
Wang A, Li S, Zhang N, Dai L, Zuo Y, Wang Y, Meng X, Wang Y. Oxidized Low-Density Lipoprotein to High-Density Lipoprotein Ratio Predicts Recurrent Stroke in Minor Stroke or Transient Ischemic Attack. Stroke. 2018 Nov;49(11):2637-2642. doi: 10.1161/STROKEAHA.118.022077.
Results Reference
derived
PubMed Identifier
30355101
Citation
Zhu B, Liu H, Pan Y, Jing J, Li H, Zhao X, Liu L, Wang D, Johnston SC, Wang Z, Wang Y, Wang Y; CHANCE Investigators. Elevated Neutrophil and Presence of Intracranial Artery Stenosis Increase the Risk of Recurrent Stroke. Stroke. 2018 Oct;49(10):2294-2300. doi: 10.1161/STROKEAHA.118.022126.
Results Reference
derived
PubMed Identifier
30089614
Citation
Wang A, Xu J, Chen G, Wang D, Johnston SC, Meng X, Lin J, Li H, Cao Y, Zhang N, Ma C, Dai L, Zhao X, Liu L, Wang Y, Wang Y. Oxidized low-density lipoprotein predicts recurrent stroke in patients with minor stroke or TIA. Neurology. 2018 Sep 4;91(10):e947-e955. doi: 10.1212/WNL.0000000000006118. Epub 2018 Aug 8.
Results Reference
derived
PubMed Identifier
29773949
Citation
Ma Y, Liu Y, Xu J, Wang Y, Wang Y, Du F. Effect of dual antiplatelet on recurrent stroke in minor stroke or TIA depends on bodyweight. Ther Clin Risk Manag. 2018 May 8;14:861-870. doi: 10.2147/TCRM.S156694. eCollection 2018.
Results Reference
derived
PubMed Identifier
29507777
Citation
Wangqin R, Wang X, Wang Y, Xian Y, Zhao X, Liu L, Li H, Meng X, Wang Y. Risk factors associated with 90-day recurrent stroke in patients on dual antiplatelet therapy for minor stroke or high-risk TIA: a subgroup analysis of the CHANCE trial. Stroke Vasc Neurol. 2017 Jul 6;2(4):176-183. doi: 10.1136/svn-2017-000088. eCollection 2017 Dec.
Results Reference
derived
PubMed Identifier
29051218
Citation
Pan Y, Cai X, Jing J, Meng X, Li H, Wang Y, Zhao X, Liu L, Wang D, Johnston SC, Wei T, Wang Y; CHANCE Investigators. Stress Hyperglycemia and Prognosis of Minor Ischemic Stroke and Transient Ischemic Attack: The CHANCE Study (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events). Stroke. 2017 Nov;48(11):3006-3011. doi: 10.1161/STROKEAHA.117.019081.
Results Reference
derived
PubMed Identifier
28289237
Citation
Lin Y, Wang A, Li J, Lin J, Wang D, Meng X, Ou L, Chen W, Zhao X, Liu L, Wang Y, Wang Y; CHANCE Investigators. Impact of Glycemic Control on Efficacy of Clopidogrel in Transient Ischemic Attack or Minor Stroke Patients With CYP2C19 Genetic Variants. Stroke. 2017 Apr;48(4):998-1004. doi: 10.1161/STROKEAHA.116.016463. Epub 2017 Mar 13.
Results Reference
derived
PubMed Identifier
27738237
Citation
Zhou Y, Pan Y, Wu Y, Zhao X, Li H, Wang D, Johnston SC, Liu L, Wang C, Meng X, Wang Y, Wang Y; CHANCE Investigators. Effect of Estimated Glomerular Filtration Rate Decline on the Efficacy and Safety of Clopidogrel With Aspirin in Minor Stroke or Transient Ischemic Attack: CHANCE Substudy (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events). Stroke. 2016 Nov;47(11):2791-2796. doi: 10.1161/STROKEAHA.116.014761. Epub 2016 Oct 13.
Results Reference
derived
PubMed Identifier
27613582
Citation
Pan Y, Jing J, Li H, Wang Y, Wang Y, He Y; CHANCE investigators. Abnormal glucose regulation increases stroke risk in minor ischemic stroke or TIA. Neurology. 2016 Oct 11;87(15):1551-1556. doi: 10.1212/WNL.0000000000003200. Epub 2016 Sep 9.
Results Reference
derived
PubMed Identifier
28959461
Citation
Wang D, Gui L, Dong Y, Li H, Li S, Zheng H, Wang A, Meng X, Liu LP, Wang YL, Wang G, Jing J, Li Z, Zhao XQ, Wang YJ. Dual antiplatelet therapy may increase the risk of non-intracranial haemorrhage in patients with minor strokes: a subgroup analysis of the CHANCE trial. Stroke Vasc Neurol. 2016 Jun 24;1(2):29-36. doi: 10.1136/svn-2016-000008. eCollection 2016 Jun.
Results Reference
derived
PubMed Identifier
27328699
Citation
Li J, Zhao X, Meng X, Lin J, Liu L, Wang C, Wang A, Wang Y, Wang Y; CHANCE Investigators. High-Sensitive C-Reactive Protein Predicts Recurrent Stroke and Poor Functional Outcome: Subanalysis of the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events Trial. Stroke. 2016 Aug;47(8):2025-30. doi: 10.1161/STROKEAHA.116.012901. Epub 2016 Jun 21.
Results Reference
derived
PubMed Identifier
27001965
Citation
Li Z, Wang Y, Zhao X, Liu L, Wang D, Wang C, Meng X, Li H, Pan Y, Wang X, Wang C, Yang X, Zhang C, Jing J, Xian Y, Johnston SC, Wang Y; CHANCE Investigators. Treatment Effect of Clopidogrel Plus Aspirin Within 12 Hours of Acute Minor Stroke or Transient Ischemic Attack. J Am Heart Assoc. 2016 Mar 21;5(3):e003038. doi: 10.1161/JAHA.115.003038.
Results Reference
derived
PubMed Identifier
26330567
Citation
Liu L, Wong KS, Leng X, Pu Y, Wang Y, Jing J, Zou X, Pan Y, Wang A, Meng X, Wang C, Zhao X, Soo Y, Johnston SC, Wang Y; CHANCE Investigators. Dual antiplatelet therapy in stroke and ICAS: Subgroup analysis of CHANCE. Neurology. 2015 Sep 29;85(13):1154-62. doi: 10.1212/WNL.0000000000001972.
Results Reference
derived
PubMed Identifier
26012640
Citation
Li J, Wang Y, Lin J, Wang D, Wang A, Zhao X, Liu L, Wang C, Wang Y; CHANCE Investigators. Soluble CD40L Is a Useful Marker to Predict Future Strokes in Patients With Minor Stroke and Transient Ischemic Attack. Stroke. 2015 Jul;46(7):1990-2. doi: 10.1161/STROKEAHA.115.008685. Epub 2015 May 26.
Results Reference
derived
PubMed Identifier
25957224
Citation
Wang Y, Pan Y, Zhao X, Li H, Wang D, Johnston SC, Liu L, Meng X, Wang A, Wang C, Wang Y; CHANCE Investigators. Clopidogrel With Aspirin in Acute Minor Stroke or Transient Ischemic Attack (CHANCE) Trial: One-Year Outcomes. Circulation. 2015 Jul 7;132(1):40-6. doi: 10.1161/CIRCULATIONAHA.114.014791. Epub 2015 May 8.
Results Reference
derived

Learn more about this trial

Clopidogrel in High-risk Patients With Acute Non-disabling Cerebrovascular Events

We'll reach out to this number within 24 hrs