Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial: a double-blind, active and placebo-controlled study.

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Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial : a double-blind, active and placebo-controlled study.

Diener, Hans-Christoph (författare): Department of Neurology, University Hospital, Essen, Germany

Sacco, Ralph L. (författare): Department of Neurology, University Hospital, Essen, Germany

Yusuf, Salim (författare): Department of Neurology, University Hospital, Essen, Germany

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Cotton, Daniel (författare): Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut, USA

Ounpuu, Stephanie (författare): Boehringer Ingelheim, Burlington, Canada

Lawton, William A. (författare): Boehringer Ingelheim Ltd, Bracknell, England

Palesch, Yuko (författare): Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, South Carolina, USA

Martin, Reneé H. (författare): Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, South Carolina, USA

Albers, Gregory W. (författare): Neurology and Neurological Sciences, Stanford University Medical Center, Palo Alto, California, USA

Bath, Philip (författare): Stroke Trials Unit, University of Nottingham, Nottingham, England

Bornstein, Natan (författare): Neurology Department, Ichilov Medical, Center, Tel-Aviv, Israel

Chan, Bernard P. L. (författare): Division of Neurology, Department of Medicine, National University Hospital, Singapore

Chen, Sien-Tsong (författare): Department of Neurology, Chang Gung Memorial Hospital, Taipei, Taiwan

Cunha, Luis (författare): Neurology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal

Dahlöf, Björn (författare): Department of Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden

De Keyser, Jacques (författare): Department of Neurology, University Medical Center Groningen, Groningen, Netherland

Donnan, Geoffrey A. (författare): National Stroke Research Institute, Austin Health, University of Melbourne, Heidelberg West, Australia

Estol, Conrado (författare): Neurological Center for Treatment and Research, Buenos Aires, Argentina

Gorelick, Philip (författare): Department of Neurology and Rehabilitation, University of Illinois, Chicago, Illinois, USA

Gu, Vivian (författare): Boehringer Ingelheim Shanghai Pharmaceuticals Co Ltd, Shanghai, China

Hermansson, Karin (författare): Boehringer Ingelheim AB, Stockholm, Sweden

Hilbrich, Lutz (författare): Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut, USA

Kaste, Markku (författare): Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland

Lu, Chuanzhen (författare): Neurology Department, Huashan Hospital, Shanghai, China

Machnig, Thomas (författare): Boehringer Ingelheim GmbH, Ingelheim, Germany

Pais, Prem (författare): St John's Medical College, Bangalore, India

Roberts, Robin (författare): Clinical Trials Methodology Group, McMaster University, Hamilton, Ontario, Canada

Skvortsova, Veronika (författare): Neurology & Neurosurgery Clinic, Russian State Medical University, Moscow, Russia

Teal, Philip (författare): Department of Medicine, Neurology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

Toni, Danilo (författare): Department of Neurological Sciences, University “La Sapienza”, Rome, Italy

VanderMaelen, Cam (författare): Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut, USA

Voigt, Thor (författare): Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut, USA

Weber, Michael (författare): Cardiology Department, SUNY Downstate College of Medicine, New York, USA

Yoon, Byung-Woo (författare): Department of Neurology, Seoul National University Hospital, Seoul, Korea

Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS), study group (författare)

von Euler, Mia, 1967- (författare)

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(creator_code:org_t)

Elsevier, 2008
2008
Engelska.
Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 7:10, s. 875-884

Relaterad länk:: https://urn.kb.se/re...; visa fler...; https://doi.org/10.1...; http://kipublication...; visa färre...

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BACKGROUND: The treatment of ischaemic stroke with neuroprotective drugs has been unsuccessful, and whether these compounds can be used to reduce disability after recurrent stroke is unknown. The putative neuroprotective effects of antiplatelet compounds and the angiotensin II receptor antagonist telmisartan were investigated in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial.METHODS: Patients who had had an ischaemic stroke were randomly assigned in a two by two factorial design to receive either 25 mg aspirin (ASA) and 200 mg extended-release dipyridamole (ER-DP) twice a day or 75 mg clopidogrel once a day, and either 80 mg telmisartan or placebo once per day. The predefined endpoints for this substudy were disability after a recurrent stroke, assessed with the modified Rankin scale (mRS) and Barthel index at 3 months, and cognitive function, assessed with the mini-mental state examination (MMSE) score at 4 weeks after randomisation and at the penultimate visit. Analysis was by intention to treat. The study was registered with ClinicalTrials.gov, number NCT00153062.FINDINGS: 20,332 patients (mean age 66 years) were randomised and followed-up for a median of 2.4 years. Recurrent strokes occurred in 916 (9%) patients randomly assigned to ASA with ER-DP and 898 (9%) patients randomly assigned to clopidogrel; 880 (9%) patients randomly assigned to telmisartan and 934 (9%) patients given placebo had recurrent strokes. mRS scores were not statistically different in patients with recurrent stroke who were treated with ASA and ER-DP versus clopidogrel (p=0.38), or with telmisartan versus placebo (p=0.61). There was no significant difference in the proportion of patients with recurrent stroke with a good outcome, as measured with the Barthel index, across all treatment groups. Additionally, there was no significant difference in the median MMSE scores, the percentage of patients with an MMSE score of 24 points or less, the percentage of patients with a drop in MMSE score of 3 points or more between 1 month and the penultimate visit, and the number of patients with dementia among the treatment groups. There were no significant differences in the proportion of patients with cognitive impairment or dementia among the treatment groups.INTERPRETATION: Disability due to recurrent stroke and cognitive decline in patients with ischaemic stroke were not different between the two antiplatelet regimens and were not affected by the preventive use of telmisartan.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Medicinska och f ...; och Neurovetenskaper

Artiklar i publikationen: Lancet Neurology

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