Levels of Inflammatory Markers in the Treatment of Stroke-An SPS3 Ancillary Study

NCT ID: NCT00579306

Last Updated: 2017-07-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

1244 participants

Study Classification

OBSERVATIONAL

Study Start Date

2005-06-30

Study Completion Date

2012-07-31

Brief Summary

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The goals of this trial are to determine the prognostic significance of an elevated level of inflammatory blood markers in people who have experienced small subcortical strokes and who are enrolled in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial.

Detailed Description

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Inflammation is increasingly recognized as playing a central role in atherosclerosis and coronary artery disease. And, peripheral blood markers of inflammation have been associated with incident and recurrent cardiac events. The relationship of these risk markers-which have the potential to be modified-to prognosis after ischemic stroke is less clear.

The Levels of Inflammatory Markers in the Treatment of Stroke (LIMITS) study will address questions about the role of inflammatory markers in secondary stroke prevention in a cost-effective manner using the well-established framework of the Secondary Prevention of Small Subcortical Strokes (SPS3) trial. The SPS3 trial is an ongoing Phase 3, multicenter secondary stroke prevention trial that focuses on preventing stroke recurrence in people with small vessel ischemic stroke, or lacunes.

The overall purpose of the LIMITS study is to determine if serum levels of inflammatory markers-such as hsCRP, serum amyloid A (SAA), CD40 ligand (CD40L), and monocyte chemoattractant protein-1 (MCP-1)-predict recurrent stroke and other vascular events among people with a history of small artery ischemic stroke. The project will also determine if these markers predict which people will respond best to dual antiplatelet therapy with clopidogrel and aspirin.

The specific aims of LIMITS are to determine if hsCRP, SAA, CD40L, and MCP-1 levels are independent risk factors for recurrent ischemic stroke, and for recurrent ischemic stroke, myocardial infarction, and death in participants in the SPS3 trial after adjusting for demographic and traditional stroke risk factors, and other treatments, using a prospective cohort of people with small subcortical strokes from the SPS3 trial. LIMITS also aims to compare the efficacy of dual versus single antiplatelet therapy among participant groups with and without elevated baseline inflammatory marker levels for the outcome of a.) recurrent stroke, and b.) recurrent ischemic stroke, myocardial infarction, or death.

Conditions

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Hypertension Stroke

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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SPS3 patient cohort

All SPS3 patients who participate in Baseline and 1-Year F/U blood draw

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patient must be randomized within 6 months of qualifying small subcortical stroke (S3) or subcortical TIA
* One of the following lacunar syndromes: PMH; pure sensory stroke; sensorimotor stroke; ataxic hemiparesis; dysarthria; hemiballism; PMH with facial sparing, horizontal gaze palsy, contralateral III palsy, contralateral VI palsy; Ataxia with contralateral III palsy; pure dysarthria
* Absence of cortical dysfunction (aphasia, apraxia, agnosia)
* No ipsilateral cervical carotid stenosis (\>= 50%) if S3 is hemispheric
* No major-risk cardioembolic sources requiring anti-coagulation
* MRI evidence of S3 that is \>=2.0 cm in diameter if DWI/bright lesion on FLAIR/T2 or \<=1.5cm hypointense lesion on FLAIR/T1, corresponding to the qualifying event (required for all brainstem events) OR multiple S3 in cerebral hemispheres of \<=1.5cm hypointense lesions on FLAIR/T1 AND absence of cortical stroke and large subcortical stroke.

Exclusion Criteria

* Disabling stroke (Ranking Scale \>= 4)
* Prior hemorrhagic stroke
* Age \<30 years
* High risk of bleeding (recurrent GI or GU bleeding, active peptic ulcer disease, etc)
* Need for long-term use of anticoagulants or other antiplatelet agents.
* Prior cortical or retinal stroke / TIA
* Prior ipsilateral carotid endarterectomy if hemispheric S3
* Impaired renal function: GFR\<40 cc/min
* Intolerance/contraindication to aspirin or clopidogrel
* Adjusted Folstein MMSE \<24
* Medical contraindication to MRI
* Pregnancy or child-bearing potential without contraception
* Other specific causes of stroke (e.g. dissection, vasculitis, drug abuse)
Minimum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role collaborator

Columbia University

OTHER

Sponsor Role lead

Responsible Party

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Mitchell S Elkind

Associate Professor of Neurology and Epidemiology (in the Sergievsy Center)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mitchell S. Elkind, MD, MS, FAAN

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Oscar Benavente, MD

Role: PRINCIPAL_INVESTIGATOR

UTHSC San Antonio (SPS3 Principal Investigator)

Robert Hart, MD

Role: PRINCIPAL_INVESTIGATOR

UTHSC San Antonio (SPS3 Principal Investigator)

Locations

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University of South Alabama

Mobile, Alabama, United States

Site Status

Mayo Clinic Scottsdale

Scottsdale, Arizona, United States

Site Status

University of Arizona Collage of Medicine

Tucson, Arizona, United States

Site Status

University of California, San Diego Medical Center

La Jolla, California, United States

Site Status

Sutter Neuroscience Institute

Sacramento, California, United States

Site Status

Melbourne Internal Medicine Associates

Melbourne, Florida, United States

Site Status

University of Miami

Miami, Florida, United States

Site Status

Mercy Medical Center

Des Moines, Iowa, United States

Site Status

University of Kentucky

Lexington, Kentucky, United States

Site Status

Boston University Medical Center

Boston, Massachusetts, United States

Site Status

Wayne State University

Detroit, Michigan, United States

Site Status

Henry Ford Health System

Detroit, Michigan, United States

Site Status

Hennepin County Medical Center

Minneapolis, Minnesota, United States

Site Status

Mayo Clinic Rochester

Rochester, Minnesota, United States

Site Status

St. Louis University

St Louis, Missouri, United States

Site Status

St. John's Mercy Medical Center

St Louis, Missouri, United States

Site Status

Cooper University Hospital,

Camden, New Jersey, United States

Site Status

Columbia University Medical Center

New York, New York, United States

Site Status

Rochester General Hospital

Rochester, New York, United States

Site Status

University of Rochester Medical Center

Rochester, New York, United States

Site Status

Helen Hayes Hospital

West Haverstraw, New York, United States

Site Status

Wake Forest University Medical Center

Winston-Salem, North Carolina, United States

Site Status

University Hospitals of Cleveland, Case Western Reserve University,Case Western Neurological Unit, 11100 Euclid Avenue, Lakeside 5508

Cleveland, Ohio, United States

Site Status

Metro Health Medical Center

Cleveland, Ohio, United States

Site Status

Oregon Health and Science University

Portland, Oregon, United States

Site Status

University of Texas South Western Medical Center

Dallas, Texas, United States

Site Status

The Methodist Hospital

Houston, Texas, United States

Site Status

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States

Site Status

Marshfield Clinic Research Foundation

Marshfield, Wisconsin, United States

Site Status

Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Site Status

Dalhousie University Center for Clinical Research

Halifax, Nova Scotia, Canada

Site Status

Hospital Charles LeMoyne Centre de recherché

Greenfield Park, Quebec, Canada

Site Status

McGill University Health Center

Montreal, Quebec, Canada

Site Status

Pontificia Universidad Catolica de Chile

Santiago, , Chile

Site Status

Hospital Naval Almirante Nef

Viña del Mar, , Chile

Site Status

Hospital-Clinica Kennedy

Guayaquil, , Ecuador

Site Status

Universidad Autonoma de Guadalajara

Guadalajara, Jalisco, Mexico

Site Status

Instituto Nacional de Neurología y Neurocirugía

Mexico City, Mexico City, Mexico

Site Status

Hospital Nacional Alberto Sabogal

Lima, , Peru

Site Status

Hospital Clinico Universitario de Santiago de Compostela

Barcelona, , Spain

Site Status

Hospital del Mar

Barcelona, , Spain

Site Status

Hospital del Sagrat Cor

Barcelona, , Spain

Site Status

Hospital Dr. Josep Trueta

Barcelona, , Spain

Site Status

Hospital Germans Trias i Pujol,

Barcelona, , Spain

Site Status

Hospital Universitario de Bellvitge, Spain

Barcelona, , Spain

Site Status

Countries

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United States Canada Chile Ecuador Mexico Peru Spain

Other Identifiers

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R01NS050724

Identifier Type: NIH

Identifier Source: secondary_id

View Link

AAAB1202

Identifier Type: -

Identifier Source: org_study_id

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