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Abstract

Objective:

We aimed to investigate whether the efficacy and safety of clopidogrel plus aspirin vs aspirin alone were consistent between patients with and without intracranial arterial stenosis (ICAS), in the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial.

Methods:

We assessed the interaction of the treatment effects of the 2 antiplatelet therapies among patients with and without ICAS, identified by magnetic resonance angiography (MRA) in CHANCE (ClinicalTrials.gov identifier NCT00979589).

Results:

Overall, 1,089 patients with MRA images available in CHANCE were included in this subanalysis, 608 patients (55.8%) with ICAS and 481 (44.2%) without. Patients with ICAS had higher rates of recurrent stroke (12.5% vs 5.4%; p < 0.0001) at 90 days than those without. But there was no statistically significant treatment by presence of ICAS interaction on either the primary outcome of any stroke (hazard ratio for clopidogrel plus aspirin vs aspirin alone: 0.79 [0.47–1.32] vs 1.12 [0.56–2.25]; interaction p = 0.522) or the safety outcome of any bleeding event (interaction p = 0.277).

Conclusions:

The results indicated higher rate of recurrent stroke in minor stroke or high-risk TIA patients with ICAS than in those without. However, there was no significant difference in the response to the 2 antiplatelet therapies between patients with and without ICAS in the CHANCE trial.

Classification of evidence:

This study provides Class II evidence that for patients with acute minor stroke or TIA with and without ICAS identified by MRA, clopidogrel plus aspirin is not significantly different than aspirin alone in preventing recurrent stroke.

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Supplementary Material

File (coinvestigators.docx)
File (figure_e-1.pdf)
File (table_e-1.pdf)

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Information & Authors

Information

Published In

Neurology®
Volume 85Number 13September 29, 2015
Pages: 1154-1162
PubMed: 26330567

Publication History

Received: February 3, 2015
Accepted: June 3, 2015
Published online: August 28, 2015
Published in print: September 29, 2015

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Disclosure

The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Study Funding

Supported by grants 2008ZX09312-008, 2011BAI08B02, 2012ZX09303, and 200902004 from the Ministry of Science and Technology, China; and the Chinese University of Hong Kong (Focused Investment Scheme B) and the Institute of Innovative Medicine, Chinese University of Hong Kong, China.

Authors

Affiliations & Disclosures

Liping Liu, MD*
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
editor of Jouenals Stroke, Neuroepidemiology
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
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1.
NONE
Legal Proceedings:
1.
NONE
Ka Sing Lawrence Wong, MD*
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Pfizer, Sanofi
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Pfizer, Sanofi
Editorial Boards:
1.
Associate Editor, STROKE, Neurology Asia Ed Board: JNNP, Eur J Neurology, Journal Neuroimaging
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
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1.
NONE
Legal Proceedings:
1.
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Xinyi Leng, PhD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Yuehua Pu, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Yilong Wang, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Dr. Yilong Wang received research support from the Ministry of Science and Technology of the People's Republic of China (No. 2011BAI08B02, 2011-2015). The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Jing Jing, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Xinying Zou, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Yuesong Pan, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Anxin Wang, MS
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Xia Meng, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Chunxue Wang, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Xingquan Zhao, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Yannie Soo, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
S. Claiborne Johnston, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
INTERACT trial DSMB member (funded by NHMRC of Australia)
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Journal Watch Neurology, Co-Editor-in-Chief Annals of Neurology, Vice Editor
Patents:
1.
Co-holder of patent on the RNA panel to identify TIA and risk stratify.
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
AstraZeneca; Sanofi (for drug and placebo donation to an NIH- sponsored trial).
Research Support, Government Entities:
1.
(1) NCRR/NCATS, CTSA, PI 2008-2014; (2) NINDS/U01, POINT Trial, PI, 2009-current
Research Support, Academic Entities:
1.
Kaiser-Permanente Adjunct Investigator
Research Support, Foundations and Societies:
1.
Grove Foundation
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Yongjun Wang, MD
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
For the CHANCE Investigators
From the Department of Neurology (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing; Center of Stroke (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (L.L., Yuehua Pu, Yilong Wang, J.J., Xinying Zou, Yuesong Pan, A.W., X.M., C.W., Xingquan Zhao, Yongjun Wang); Department of Medicine and Therapeutics (K.S.L.W., X.L., Y.S.), the Chinese University of Hong Kong, China; and Dell Medical School (S.C.J.), The University of Texas at Austin.

Notes

Correspondence to Dr. Yongjun Wang: [email protected]
*
These authors contributed equally to this work.
CHANCE coinvestigators are listed on the Neurology® Web site at Neurology.org.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

Author Contributions

Dr. Liping Liu and Dr. Ka Sing Lawrence Wong contributed to study design, literature search, data analysis, data interpretation, and manuscript preparation. Dr. Xinyi Leng contributed to literature search, data analysis and interpretation, figures, and manuscript preparation. Dr. Yuehua Pu contributed to data collection and interpretation and manuscript preparation. Dr. Yilong Wang contributed to study design and data interpretation, and provided critical and essential comments on the manuscript. Dr. Jing Jing and Dr. Xinying Zou contributed to data collection and image analysis and interpretation. Dr. Yuesong Pan and Mr. Anxin Wang contributed to statistical analysis, data interpretation, and figures. Dr. Xia Meng contributed to data collection and image interpretation. Dr. Chunxue Wang, Dr. Xingquan Zhao, and Dr. Yannie Soo contributed to study design and provided critical and essential comments on the manuscript. Dr. S. Claiborne Johnston and Dr. Yongjun Wang were the principal investigators of the CHANCE study, and contributed to study design, data analysis and interpretation, and provided critical comments on the manuscript.

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