posted on 2016-11-21, 09:24authored byP. M. Bath, J. P. Appleton, M. Beridze, H. Christensen, R. A. Dineen, L. Duley, T. J. England, S. Heptinstall, M. James, K. Krishnan, H. S. Markus, S. Pocock, A. Ranta, Thompson G. Robinson, K. Flaherty, P. Scutt, G. S. Venables, L. J. Woodhouse, N. Sprigg
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.
Funding
The TARDIS start-up phase was funded by the British Heart Foundation (grant
PG/08/083/25779, 1 April 2009 – 30 September 2012); the TARDIS main phase is
funded by the National Institute of Health Research (NIHR) Heath Technology
Assessment (HTA) Programme (grant 10/104/24, 1 October 2012 – 30 September
2017, http://www.nets.nihr.ac.uk/projects/hta/1010424).
This paper presents independent research funded by the National Institute for Health
Research (NIHR). The views expressed are those of the author(s) and not necessarily
those of the NHS, the NIHR or the Department of Health.
PMB is Stroke Association Professor of Stroke Medicine; PMB and TGR are NIHR Senior
Investigators.
History
Citation
International Journal of Stroke, November 3, 2016 1747493016677988
Author affiliation
/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences
Version
AM (Accepted Manuscript)
Published in
International Journal of Stroke
Publisher
SAGE Publications (UK and US), World Stroke Organization