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The Canadian American Ticlopidine Study (CATS) in thromboembolic stroke
M Gent1, J A Blakely, J D Easton
1Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Lancet (London, England)
|June 3, 1989
Summary
Ticlopidine significantly reduced the risk of recurrent stroke, heart attack, or vascular death in patients after a thromboembolic stroke. This medication proved beneficial for both men and women, with manageable side effects.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Clinical Trials
Background:
- Thromboembolic stroke poses a significant risk for recurrent cardiovascular events.
- Effective secondary prevention strategies are crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of ticlopidine in preventing subsequent stroke, myocardial infarction, or vascular death.
- To assess the safety and tolerability of ticlopidine in patients with recent thromboembolic stroke.
Main Methods:
- The Canadian American Ticlopidine Study (CATS) was a randomized, double-blind, placebo-controlled trial.
- 1072 patients were enrolled across 25 centers within 4 months of a qualifying stroke.
- Patients were treated with ticlopidine (250 mg twice daily) or placebo for up to 3 years.
Main Results:
- Ticlopidine reduced the combined event rate of stroke, myocardial infarction, or vascular death by 30.2% (p=0.006).
- Risk reduction was observed in both men (28.1%) and women (34.2%).
- Adverse events included reversible neutropenia, rash, and diarrhea, with severe cases occurring in approximately 1-2% of patients.
Conclusions:
- Ticlopidine demonstrates a significant beneficial effect in reducing the risk of major vascular events after a thromboembolic stroke.
- The drug is effective in both male and female patient populations.
- While side effects exist, they are generally reversible, supporting ticlopidine's role in secondary stroke prevention.