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Study aim
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To assess the efficacy of ticagrelor plus aspirin in comparison with clopidogrel plus aspirin in reduce of minor non-cardioembolic ischemic stroke or high risk TIA recurrence during first 3 months
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Design
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A randomized, controlled, active comparator arm, outcome assessor blind, parallel group design on 90 ischemic stroke patients with block randomization method
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Settings and conduct
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This is a randomized, controlled active comparator arm, outcome assessor blind on 90 patient with diagnosis of ischemic stroke admitted in Bou-Ali Sina Hospital, Sari, Iran
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Participants/Inclusion and exclusion criteria
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Inclusion criteria: age>40, signing inform consent,
recent ischemic stroke within 24 h, diagnosed by brain CT or MRI
mild stroke with NIHSS =<8,high risk TIA with ABCD >4,
no cardioembolic source such as low E/F, MS, AF ,...
no specific etiology such as dissection, vasculitis, ...
no carotid stenosis > 50 % in side of involvement
Exclusion criteria:history of hypersensitivity to consumptive drug
any indication for anticoagulant therapy
acute phase treatment with intravenous thrombolysis or thrombectomy
any contraindication for consumptive drug
history of intracranial hemorrhage
history of GI bleeding during past 6 m
candidate for endarterectomy
history of coagulopathy
active hemorrhagic diatesis during randomization
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Intervention groups
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comparator gruop will be treat with ASA 325 mg stat and clopidogrel 300 mg stat, then ASA 80 mg and clopidogrel 75 mg daily for 21 days.
intervention group will be treat with ASA 325 mg stat and ticagrelor 180 mg stat, then ASA 80 mg daily and ticagrelor 90 mg BID for 21 days.
Then all groups will be treat with ASA 80 mg daily after day 21.
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Main outcome variables
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ischemic stroke recurrence during first 3 months and major bleeding event