Although our NMA did not find a superiority of ticagrelor plus aspirin, it was at least as effective and safe as aspirin plus clopidogrel in stroke prevention, patients with CYP2C19 Loss-of-Function Carriers [16], large-artery atherosclerosis [15] and other higher risk for recurrent ischemia but lower risk for hemorrhage may benefit from the ticagrelor plus aspirin. Here, CYP2C19 is linked to ischemia.