Wang A, Meng X, Tian X, et al. - Patients with CYP2C19 loss-of-function alleles who received dual antiplatelet therapy after minor stroke or transient ischemic attack were analyzed and it was found that bleeding events mostly happened within the 21-day dual antiplatelet therapy stage and were generally mild.

• From the CHANCE-2 trial (Clopidogrel with aspirin in High-risk patients with Acute Non-disabling Cerebrovascular Events II), a total of 6,412 patients were included.

• These patients suffered 250 (3.9%) bleeding events, which occurred mainly within the 21 days of dual antiplatelet therapy (200 cases, 3.1%).

• In multivariate analysis, increased bleeding was revealed in relation to treatment with ticagrelor-aspirin vs clopidogrel-aspirin (hazard ratio [HR], 2.21; 95% confidence interval [CI], 1.68-2.89).

• A lower risk of bleeding was observed in relation to current smoking (HR, 0.70; 95% CI, 0.52-0.95).

• Higher risk of bleeding in relation to ticagrelor-aspirin vs clopidogrel-aspirin was evident in patients aged <65 years (HR, 2.87; 95% CI, 1.95-4.22) and those without diabetes mellitus (HR, 2.65; 95% CI, 1.88-3.73).