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Sponsor: | University of British Columbia |
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Collaborator: |
National Institute of Neurological Disorders and Stroke (NINDS) |
Information provided by (Responsible Party): | University of British Columbia |
ClinicalTrials.gov Identifier: | NCT00059306 |
The goal of this study is to learn if combination antiplatelet therapy (aspirin and clopidogrel) is more effective than aspirin alone for the prevention of recurrent stroke and cognitive decline, and if intensive blood pressure control is associated with fewer recurrent strokes and cognitive decline.
On July 21, 2011 the DSMB recommended terminating the anti platelet arm of the study due to an imbalance of overall and major non-CNS hemorrhagic SAE's and total deaths in the investigational anti platelet combination of aspirin + clopidogrel and an interim statistical analysis that demonstrated futility in the investigational anti platelet arm. It was recommended that patients be continued on standard care of aspirin mono therapy until their study close-out visit. Also, recommended the continuation and completion of the plood pressure arm following the protocol.
Condition | Intervention | Phase |
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Cerebrovascular Accident Hypertension |
Drug: aspirin Drug: clopidogrel Other: Target of Blood Pressure Other: placebo |
Phase 3 |
Study Type: | Interventional |
Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
Official Title: | Secondary Prevention of Small Subcortical Strokes (SPS3) Trial |
Estimated Enrollment: | 3000 |
Study Start Date: | February 2003 |
Estimated Study Completion Date: | April 2012 |
Estimated Primary Completion Date: | April 2012 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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Active Comparator: Antiplatelet
Participants receive aspirin + placebo OR aspirin + clopidogrel
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Drug: aspirin
Participants receive aspirin + placebo, specifically: aspirin (325 mg) with placebo (an inactive substance). Participants will take 1 of each pill a day until the end of the study.
Drug: clopidogrel
Participants will receive aspirin + clopidogrel, specifically: aspirin (325 mg) with clopidogrel (75 mg)-- Participants will take 1 of each pill a day until the end of the study.
Other: placebo
an inactive substance
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Active Comparator: Blood pressure
The goal of the blood pressure aspect of this trial is to find out if lowering blood pressure after stroke helps to prevent recurrent stroke and preserves cognition.
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Other: Target of Blood Pressure
Participants will be assigned to one of 2 groups of blood pressure control. The difference between the two groups is the target level of systolic blood pressure—either 130-149 mmHg or below 130 mmHg; to do so, the scientists will use medications that are already in the market for blood pressure management.
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Stroke is damage to the brain caused by problems in the blood vessels. Strokes often cause paralysis, loss of sensation and speech, and other problems. A lacunar or small Subcortical stroke affects the inner part of the brain causing small "pea sized" areas of damage due to blockage of small blood vessels within the brain.
This multi-center study will recruit 3000 participants (20 percent of whom will be Hispanic) to find out if using aspirin and clopidogrel is more effective than using aspirin alone to prevent recurrent stroke in patients with lacunar stroke confirmed by MRI, and if lowering a patient's blood pressure below the usual limits will also help prevent recurrent stroke and maintain thinking ability. Both aspirin and clopidogrel are widely-used for blood clotting and stroke prevention. Investigators intend to find out if using the drugs together is more effective than using aspirin alone.
Participants will be randomly assigned to one of 2 types of treatment: either aspirin alone or the combination of aspirin and clopidogrel. In addition, participants will be assigned to one of 2 groups of blood pressure control. The difference between the two groups is the target level of systolic blood pressure—either 130-149 or below 130. The goal of the blood pressure aspect of this trial is to find out if lowering blood pressure after stroke helps to prevent recurrent stroke and preserves cognition.
Ages Eligible for Study: | 30 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
INCLUSION:
Small subcortical ischemic stroke or subcortical TIA.
Inclusion criteria are based on TOAST criteria supplemented by required MRI data. All of the following criteria must be met:
EXCLUSION:
To be eligible for entry into the study, the patient must not meet any of the criteria listed below:
United States, Alabama | |
University of Southern Alabama Stroke Center | |
Mobile, Alabama, United States, 36617 | |
United States, Arizona | |
Catholic Healthcare West | |
Phoenix, Arizona, United States, 85013 | |
Mayo Clinic Scottsdale | |
Scottsdale, Arizona, United States, 85259 | |
University of Arizona, Department of Neurology | |
Tucson, Arizona, United States, 85724 | |
United States, California | |
University of California San Diego Medical Center | |
San Diego, California, United States, 92103-8466 | |
University of California San Francisco-Fresno | |
San Francisco-Fresno, California, United States | |
United States, Colorado | |
Denver | |
Englewood, Colorado, United States | |
United States, Florida | |
Melbourne | |
Melbourne, Florida, United States | |
Miami-University of Miami, Miller School of Medicine | |
Miami, Florida, United States, 33136 | |
United States, Georgia | |
Emory University, Grady Health System | |
Atlanta, Georgia, United States, 30303 | |
United States, Iowa | |
Mercy Medical Center-Ruan Neurology Clinical Research | |
Des Moines, Iowa, United States, 50314 | |
United States, Kentucky | |
University of Kentucky, Aging/Stroke Program | |
Lexington, Kentucky, United States, 40506-0230 | |
United States, Maryland | |
Suburban Hospital | |
Bethesda, Maryland, United States | |
United States, Massachusetts | |
Boston University | |
Boston, Massachusetts, United States, 02118 | |
United States, Michigan | |
Wayne State | |
Detroit, Michigan, United States, 48201 | |
Henry Ford Hospital, Department of Neurology | |
Detroit, Michigan, United States, 48202 | |
United States, Minnesota | |
Berman Center | |
Minneapolis, Minnesota, United States, 55404 | |
Mayo Stroke Center KA-SL-13 | |
Rochester, Minnesota, United States, 55905 | |
United States, Missouri | |
University of Washington | |
Sant Louis, Missouri, United States | |
Tenet Health, St. Louis University | |
St. Louis, Missouri, United States, 63110 | |
St. John's Mercy | |
St. Louis, Missouri, United States, 63141 | |
United States, New Jersey | |
Cooper University Hospital | |
Camden, New Jersey, United States, 08103 | |
United States, New York | |
Buffalo | |
Buffalo, New York, United States | |
Helen Hayes Hospital | |
Haverstraw, New York, United States, 10993 | |
Columbia University Medical Center | |
New York, New York, United States, 10032 | |
University of Rochester | |
Rochester, New York, United States, 14642 | |
Rochester General Hospital | |
Rochester, New York, United States, 14621 | |
United States, North Carolina | |
Wake Forest University, Sciences-Neurology | |
Winston-Salem, North Carolina, United States, 27157-1078 | |
United States, Ohio | |
Metrohealth Medical Center | |
Cleveland, Ohio, United States, 44109 | |
Case Western | |
Cleveland, Ohio, United States, 44106 | |
Ohio State University, Division of Stroke | |
Columbus, Ohio, United States, 43210 | |
United States, Oregon | |
Oregon Health and Science University | |
Portland, Oregon, United States, 97239 | |
United States, Tennessee | |
Vanderbilt University Medical Center | |
Nashville, Tennessee, United States, 37232 | |
United States, Texas | |
University of Texas Southwestern | |
Dallas, Texas, United States, 75390-8897 | |
Scurlock Stroke Center | |
Houston, Texas, United States, 77030 | |
University of Texas Health Science Center | |
San Antonio, Texas, United States, 78229-3900 | |
United States, Washington | |
University of Washington | |
Seattle, Washington, United States, 98104-2499 | |
United States, Wisconsin | |
Marshfield Clinic, Department of Neurology | |
Marshfield, Wisconsin, United States, 54449 | |
Medical College of Wisconsin-Neurology | |
Milwaukee, Wisconsin, United States, 53226 | |
Canada, Alberta | |
Calgary Health | |
Calgary, Alberta, Canada, T2N 2T9 | |
Canada, British Columbia | |
SPS3 Coordinating Center | |
Vancouver, British Columbia, Canada, V6T 2B5 | |
Canada, Nova Scotia | |
Halifax | |
Halifax, Nova Scotia, Canada, B3H 4V7 | |
Canada, Ontario | |
Ottawa Hospital General Campus | |
Ottawa, Ontario, Canada, K1H 8L6 | |
Canada, Quebec | |
Greenfield Park | |
Greenfield Park, Quebec, Canada, J4V 2H1 | |
McGill-Montreal General | |
Montreal, Quebec, Canada, H3G 1A4 | |
McGill-Jewish General | |
Montreal, Quebec, Canada, H37 1E2 | |
CHA-Hospital de l'Enfant-Jesus | |
Quebec City, Quebec, Canada, G1J 1Z4 | |
Chile | |
Hospital Clinico de la Universidad Católica de Chile | |
Santiago, Chile | |
Hospital Naval Almirante Nef, 'Subida Alessandri s/n, Hall A, Oficina 9 | |
Viña del Mar, Chile, 2530116 | |
Ecuador | |
Hospital-Clinica Kennedy | |
Guayaquil, Ecuador | |
Mexico | |
Hospital de La Universidad Autonoma de Nuevo Leon | |
Monterrey, Nuevo Leon, Mexico, 644460 | |
Antiguo Hospital Civil de Guadalajara | |
Guadalajara, Mexico, 44280 | |
Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez | |
Mexico City, Mexico, 14269 | |
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zuibrán | |
Mexico City, Mexico, 14000 | |
Peru | |
Hospital Sabogal Essalud-Unidad de Investigacion | |
Bellavista-Callao, Lima, Peru | |
Spain | |
Hosp. Universitario Germans Trias I Pujol | |
Badalona, Spain, 08916 | |
Hospital Del Mar, Passeig Marítim 25-29 | |
Barcelona, Spain, 08003 | |
Hospital del Sagrat Cor. Quinta de Salut I'Alianca, c/Viladomat 288 | |
Barcelona, Spain, 08029 | |
Hospital de la Santa Creu I Sant Pau, c/Sant Antoni Maria Claret, 167 | |
Barcelona, Spain, 08025 | |
Hosp. Parc Tauli de Sabadell | |
Barcelona, Spain, 08208 | |
Hosp. de Girona Dr. Josep Trueta | |
Girona, Spain, 17007 | |
Hospital La Paz | |
Madrid, Spain, 28046 | |
Universidad de Santiago de Compostela, Facultad de Medicina y Odontologia | |
Santiago de Compostela, Spain, 15782 |
Principal Investigator: | Oscar Benavente, M.D. | University of Texas |
Principal Investigator: | Robert Hart, M.D. | University of Texas |
Responsible Party: | University of British Columbia |
ClinicalTrials.gov Identifier: | NCT00059306 History of Changes |
Other Study ID Numbers: | R01NS38529, CRC |
Study First Received: | April 23, 2003 |
Last Updated: | September 20, 2011 |
Health Authority: | United States: Food and Drug Administration |
stroke hypertension high blood pressure lacunar stroke |
subcortical stroke aspirin clopidogrel |
Hypertension Cerebral Infarction Stroke Vascular Diseases Cardiovascular Diseases Brain Infarction Brain Ischemia Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Aspirin Clopidogrel Anti-Inflammatory Agents, Non-Steroidal Analgesics, Non-Narcotic |
Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions Anti-Inflammatory Agents Therapeutic Uses Antirheumatic Agents Fibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Cardiovascular Agents Hematologic Agents Platelet Aggregation Inhibitors Cyclooxygenase Inhibitors |