Stroke Trial Flashcards
What is this trial?
Patients with acute ischemic stroke <3hrs were randomized to IV t-PA (0.9mg/kg) or placebo and assessed for 4-point improvement in NIHSS or resolution of neurologic deficits within 24hrs. Clinical outcomes were also assessed at 3months.
Results:
No difference in neurologic outcome at 24hours.
At 3-months, patients given with IV t-PA have minimal or no disability.
NINDS T-PA Trial (National Institute of Neurological Disorders and Stroke t-PA) -1995
What is this trial?
Patients with acute ischemic stroke <6hours were randomized to t-PA at 1.1mg/kg
Results: No difference in disability using ITT. However, there were major protocol violations.
ECASS (European Australian Cooperative Acute Stroke Study)
What is this trial?
Patients with acute ischemic stroke <6hrs were randomized to rt-PA 0.9mg/kg or placebo.
Results: No significant difference in the rate of a favorable outcome at 3-months between t-PA and placebo-treated group.
ECASS-II
What is this trial?
Patients with acute ischemic stroke within 3 to 4.5hrs were randomized to rt-PA 0.9mg/kg or placebo.
Results: Significant more patients in rt-PA treated had favorable outcomes at 3 months (52.4% vs 45.2%). The incidence of intracranial hemorrhage was higher with rt-PA
ECASS- IIII (2008)
What is this trial?
Patients with acute ischemic stroke within 3hrs were given 0.6mg/kg IV rt-PA as single-arm, open-label study
Results: 36.9% achieved an mRS of 0 -1 at 3 months, symptomatic ICH occurred in 5.8%.
Data is comparable with published data using IV rt-PA.
Japanese Alteplase Clinical Trial (J-ACT)
What is this trial?
Patients with acute ischemic stroke within 4.5hours
who are eligible for thrombolytic therapy to low-dose intravenous alteplase (0.6 mg per kilogram of body weight) VS the standard dose (0.9 mg per kilogram).
Results:
Low-dose alteplase was noninferior in the ordinal analysis of modified Rankin scale scores (unadjusted common odds ratio, 1.00; 95% CI, 0.89 to 1.13; P=0.04 for noninferiority).
Major symptomatic intracerebral hemorrhage occurred in 1.0% of the participants in the low-dose group and in 2.1% of the participants in the standard-dose group (P=0.01); fatal events occurred within 7 days in 0.5% and 1.5%, respectively (P=0.01).
Mortality at 90 days did not differ significantly between the two groups (8.5% and 10.3%, respectively; P=0.07).
ENCHANTED Trial
What is this trial?
Patients with acute ischemic stroke within 6hrs were randomized to rt-PA 0.9mg/kg and placebo. No upper limit of age and broader BP eligibility.
Results:
The proportion of alive and independent at 6 months was 37% in the rTPA versus 35% in the placebo group
More deaths during 7 days.
At 6 months, 27% of patients died in both groups.
IST III (Third- International Stroke Trial)
What is CHANCE Trial?
Stroke patients within 24hrs of stroke
Mild ischemic stroke (NIHSS 0-5) or high risk TIA (ABCD2 > 3)
Clopidogrel 300mg then 75mg OD + Aspirin 75mg For 21 days then Clopidogrel 75mg alone for 90 days vs Aspirin75mg OD for 90 days.
Result: The rate of a recurrent stroke at 90 days were Aclopi-Aspi (8.2%) vs ASA alone (11.7%)
Which trial studies on Citicholine which showed global recovery at 90 days? (within 24hrs Citicholine 1000mg Q12 x 6 weeks)
A. ICTUS trial B. CASTA trial C. CATCH Trial D. CHIMES Trial E. CHANCE Trial
A. ICTUS trial
International Citicholine Trial on Acute Stroke
Which trial studies on Cerebrolysin showed no overall difference in outcomes between those who received Cerebrolysin in the placebo group at 90 days? (within 12hrs Cerebrolysin 30ml IV x 10 days)
A. ICTUS trial B. CASTA trial C. CATCH Trial D. CHIMES Trial E. CHANCE Trial
B. CASTA trial
(Cerebrolysin in Patients with Acute Ischemic Stroke in Asia
Which trial studies on NEUROAID showed a reduction in risk of recurrent fatal or non-fatal vascular events during 3 months of treatment? (within 72hrs Neuroaid 4caps TID x 90 days)
A. ICTUS trial B. CASTA trial C. CATCH Trial D. CHIMES Trial E. CHANCE Trial
D. CHIMES Trial
Among these neuroprotectants, which came from extract of nine herbal and five animal components in a capsule form?
A. Citicholine B. Cerebrolysin C. Amantadine D. Neuroaid E. Phosphatidylcholine
D. Neuroaid
Among these neuroprotectants, which is composed of low-molecular-weight peptides and free amino acids?
A. Citicholine B. Cerebrolysin C. Amantadine D. Neuroaid E. Phosphatidylcholine
B. Cerebrolysin
Among these neuroprotectants, which has a fullname of Cytidine 5’-diphosphate-choline (CDP-Choline)?
A. Citicholine B. Cerebrolysin C. Amantadine D. Neuroaid E. Phosphatidylcholine
A. Citicholine
