Study procedures
bleeding, HTN, stroke, hemorrhagic, Hemorrhagic transformation, ischemic stroke, cardio-embolic stroke, hemorrhage, hypertension, infarct
BLEEDING, ISCHEMIC HEART DISEASE, ACUTE STROKE, HYPERLIPIDEMIA, STROKE, MINOR, DIABETES MELLITUS (DM), HTN, ISCHEMIC STROKE, HEMORRHAGE, IHD, HYPERTENSION, INFARCT, COMPLICATIONS
We collected the following data: age, sex, medical history of hypertension (HTN), diabetes mellitus (DM), ischemic heart disease (IHD), hyperlipidemia, tobacco use, and the time from symptoms onset to the start of treatment.We diagnosed ischemic stroke based on the specific clinical history and examination and MRI brain using stroke protocol: T1W, T2W, FLAIR, DWI, T2 echo gradient, and MRA of all intra-cerebral vessels.Before randomization, all the patients assessed for eligibility to participate in the trial underwent 12-lead routine ECG and transthoracic echocardiography, and immediately after randomization and receiving loading antiplatelet treatment, every patient enrolled in our trial underwent 24 h of continuous cardiac rhythm monitoring and transesophageal echocardiography, and we excluded patients with major or minor risk factors for cardio-embolic stroke.All the patients in our study underwent carotid duplex and baseline laboratory investigations (lipid profile, liver functions, coagulation profile, complete blood count, and blood sugar).We estimated the safety of loading ticagrelor by looking at hemorrhagic complications assessed using the PLATO bleeding definition [Hemorrhagic transformation of the infarct was determined by performing a follow-up CT brain scan after 2 days and after 1 week or discharge to detect the hemorrhage; additionally, the European Cooperative Acute Stroke Study (ECASS) classification [We evaluated clinical improvement using five factors: the first two factors assessed the difference between NIHSS at baseline and the 2nd day and the difference between NIHSS at baseline and (the 7th day of discharge) in each patient. A decrease of four points or more in the NIHSS score was considered a significant improvement [The third and fourth factors assessed mRS after 1 week of discharge and after 90 days, and all of our patients had baseline mRS of zero. mRS ≤ 2 was considered a favorable outcome [The fifth factor was the total number of days each patient spent in the hospital.