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Clinical Trial
. 2017 Jan 24;88(4):379-385.
doi: 10.1212/WNL.0000000000003534. Epub 2016 Dec 21.

Relationship between risk factor control and vascular events in the SAMMPRIS trial

Tanya N Turan  1 , Azhar Nizam  2 , Michael J Lynn  2 , Brent M Egan  2 , Ngoc-Anh Le  2 , Maria F Lopes-Virella  2 , Kathie L Hermayer  2 , Jamie Harrell  2 , Colin P Derdeyn  2 , David Fiorella  2 , L Scott Janis  2 , Bethany Lane  2 , Jean Montgomery  2 , Marc I Chimowitz  2
Affiliations
Clinical Trial

Relationship between risk factor control and vascular events in the SAMMPRIS trial

Tanya N Turan et al. Neurology. .

Abstract

Objective: The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study is the first stroke prevention trial to include protocol-driven intensive management of multiple risk factors. In this prespecified analysis, we aimed to investigate the relationship between risk factor control during follow-up and outcome of patients in the medical arm of SAMMPRIS.

Methods: Data from SAMMPRIS participants in the medical arm (n = 227) were analyzed. Risk factors were recorded at baseline, 30 days, 4 months, and then every 4 months for a mean follow-up of 32 months. For each patient, values for all risk factor measures were averaged and dichotomized as in or out of target.

Results: Participants who were out of target for systolic blood pressure and physical activity, as well as those with higher mean low-density lipoprotein cholesterol and non-high-density lipoprotein, were more likely to have a recurrent vascular event (stroke, myocardial infarction, or vascular death) at 3 years compared to those who had good risk factor control. In the multivariable analysis, greater physical activity decreased the likelihood of a recurrent stroke, myocardial infarction, or vascular death (odds ratio 0.6, confidence interval 0.4-0.8).

Conclusions: Raised blood pressure, cholesterol, and physical inactivity should be aggressively treated in patients with intracranial atherosclerosis to prevent future vascular events. Physical activity, which has not received attention in stroke prevention trials, was the strongest predictor of a good outcome in the medical arm in SAMMPRIS.

Clinicaltrialsgov identifier: NCT00576693.

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Figures

Figure
Figure. Fitted logistic regression of combined endpoint (stroke, myocardial infarction, or vascular death) predicted by physical activity (Physician-based Assessment and Counseling for Exercise [PACE] score) averaged from baseline until the first event or end of follow-up
Maximum follow-up was 3 years. The blue shaded band represents 95% confidence intervals for the probability of the event. The markers represent the observed data.
See this image and copyright information in PMC

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References

    1. Gorelick PB, Wong KS, Bae HJ, Pandey DK. Large artery intracranial occlusive disease, a large worldwide burden but a relatively neglected frontier. Stroke 2008;39:2396–2399. - PubMed
    1. Chimowitz MI, Lynn MJ, Howlett-Smith H, et al. . Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 2005;352:1305–1316. - PubMed
    1. Mazighi M, Tanasescu R, Ducrocq X, et al. . Prospective study of symptomatic atherothrombotic intracranial stenoses: the GESICA study. Neurology 2006;66:1187–1191. - PubMed
    1. Turan TN, Cotsonis G, Lynn MJ, Chaturvedi S, Chimowitz M; Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators. Relationship between blood pressure and stroke recurrence in patients with intracranial arterial stenosis. Circulation 2007;115:2969–2975. - PubMed
    1. Chaturvedi S, Turan TN, Lynn MJ, et al. . Risk factor status and vascular events in patients with symptomatic intracranial stenosis. Neurology 2007;69:2063–2068. - PubMed

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