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TIA, indicating moderate disability or worse at baseline; an NIHSS score of 4 or more at randomization; a clear indication for anticoagulation therapy (presumed cardiac source of embolus, such as atrial fibrillation or prosthetic cardiac valve) or a contraindication to clopidogrel or aspirin; history of intracranial hemorrhage; anticipated requirement for long-term nonstudy antiplatelet drugs or for nonsteroidal antiinflammatory drugs affecting platelet function; heparin therapy or oral anticoagulation therapy within 10 days before randomization; gastrointestinal bleeding or major surgery within the previous 3 months; planned or probable revascularization (any angioplasty or vascular surgery) within 3 months after screening (if clinically indicated, vascular imaging was to be performed before randomization, whenever possible); planned surgery or interventional treatment requiring cessation of the study drug; TIA or minor stroke caused by angiography or surgery; or severe noncardiovascular coexisting condition, with a life expectancy of less than 3 months.

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Challenging ticagrelor's claimed reduction in the rate of definite stent thrombosis versus clopidogrel: Insights from the FDA reports.

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This may be related to the regional difference in anti-microbial resistance that affects the outcome of therapy.

In addition, this method may not be representative of long-term adherence patterns because patients may exhibit white-coat adherence, or improved medication-taking behavior in the 5 days before and 5 days after a health care encounter.

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Ginkgo biloba extract, advertised as improving cognitive functioning, has been reported to cause spontaneous bleeding, and it may interact with anticoagulants and antiplatelet agents.

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We are less confident about this conclusion.

In addition, the majority of data suggesting this finding are industry sponsored, and aspirin has proven effective and safe for decades in non-industry trials, making this a more staid and robustly supported first line choice.

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