Baseline characteristics of the 3096 patients recruited into the 'Triple Antiplatelets for Reducing Dependency after Ischemic Stroke' trial.
Background The risk of recurrence following ischemic stroke or transient ischemic attack is highest immediately after the event. Antiplatelet agents are effective in reducing the risk of recurrence and two agents are superior to one in the early phase after ictus. Design The triple antiplatelets for reducing dependency after ischemic stroke trial was an international multicenter prospective randomized open-label blinded-endpoint trial that assessed the safety and efficacy of short-term intensive antiplatelet therapy with three agents (combined aspirin, clopidogrel and dipyridamole) as compared with guideline treatment in acute ischemic stroke or transient ischemic attack. The primary outcome was stroke recurrence and its severity, measured using the modified Rankin Scale at 90 days. Secondary outcomes included recurrent vascular events, functional measures (cognition, disability, mood, quality of life), and safety (bleeding, death, serious adverse events). Data are number (%) or mean (standard deviation, SD). Results Recruitment ran from April 2009 to March 2016; 3096 patients were recruited from 106 sites in four countries (Denmark 1.6%, Georgia 2.7%, New Zealand 0.2%, UK 95.4%). Randomization characteristics included: age 69.0 (10.1) years; male 1945 (62.8%); time onset to randomization 29.4 (11.9) h; stroke severity (National Institutes for Health Stroke Scale) 2.8 (3.6); blood pressure 143.5 (18.2)/79.5 (11.4) mmHg; IS 2143 (69.2%), transient ischemic attack 953 (30.8%). Conclusion Triple antiplatelets for reducing dependency after ischemic stroke was a large trial of intensive/triple antiplatelet therapy in acute ischemic stroke and transient ischemic attack, and included participants from four predominantly Caucasian countries who were representative of patients in many western stroke services.
1 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, UK.|2 Stroke, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, UK.
Philip Mw
PM
Bath
1 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, UK.|2 Stroke, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, UK.
Jason P
JP
Appleton
3 Hospital of War Veterans, Tbilisi, Georgia.
Maia
M
Beridze
4 Department of Neurology, University of Copenhagen, Copenhagen Bispebjerg and Frederiksberg Hospital, Denmark.
Hanne
H
Christensen
5 Radiological Sciences Research Group, Division of Clinical Neuroscience, University of Nottingham, Queens Medical Centre Campus, Nottingham, UK.
Robert A
RA
Dineen
6 Nottingham Clinical Trials Unit, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
Lelia
L
Duley
7 Vascular Medicine, Division of Medical Sciences & GEM, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.
Timothy J
TJ
England
1 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, UK.
Stan
S
Heptinstall
8 Health Economics, Division of Rehabilitation and Ageing, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
Marilyn
M
James
1 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, UK.
Kailash
K
Krishnan
9 Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
Hugh S
HS
Markus
10 Medical Statistics Unit, London School of Hygiene & Tropical Medicine, London, UK.
Stuart
S
Pocock
11 Department of Neurology, Wellington Hospital and University of Otago, Wellington, New Zealand.
Annemarei
A
Ranta
12 Department of Cardiovascular Sciences, University of Leicester, Leicester Royal Infirmary, Infirmary Square, and NIHR Cardiovascular Biomedical Unit, The Glenfield Hospital, Leicester, UK.
Thompson G
TG
Robinson
1 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, UK.
Katie
K
Flaherty
1 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, UK.
Polly
P
Scutt
13 Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK.
Graham S
GS
Venables
1 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, UK.
Lisa J
LJ
Woodhouse
1 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, UK.|2 Stroke, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, UK.
Nikola
N
Sprigg
D000368:Aged; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology; D000077144:Clopidogrel; D004176:Dipyridamole / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D004176:Dipyridamole; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin
Acute ischemic stroke; acute transient ischemic attack; aspirin; bleeding; clopidogrel; dipyridamole; randomized controlled trial