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Previous randomized trials have demonstrated the superior efficacy of acute short-term dual-antiplatelet therapy over antiplatelet monotherapy for secondary stroke prevention after a transient ischemic attack (TIA) or minor stroke. Extending dual antiplatelet therapy to patients excluded from these trials, such as those with more than minor stroke symptoms or those presenting beyond 12 or 24 hours after symptom onset, could allow more patients to benefit. Accordingly, the ATAMIS investigators assigned 3000 patients (65% men; mean age, 66 years) with mild-to-moderate stroke (National Institutes of Health Stroke Scale [NIHSS] score, 4–10) within 48 hours after symptom onset across 66 hospitals in China to receive either open-label clopidogrel…