Stroke Clinical Trial
Official title:
Levels of Inflammatory Markers in the Treatment of Stroke
The goals of this trial are to determine the prognostic significance of an elevated level of inflammatory blood markers in people who have experienced small subcortical strokes and who are enrolled in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial.
Inflammation is increasingly recognized as playing a central role in atherosclerosis and
coronary artery disease. And, peripheral blood markers of inflammation have been associated
with incident and recurrent cardiac events. The relationship of these risk markers—which have
the potential to be modified—to prognosis after ischemic stroke is less clear.
The Levels of Inflammatory Markers in the Treatment of Stroke (LIMITS) study will address
questions about the role of inflammatory markers in secondary stroke prevention in a
cost-effective manner using the well-established framework of the Secondary Prevention of
Small Subcortical Strokes (SPS3) trial. The SPS3 trial is an ongoing Phase 3, multicenter
secondary stroke prevention trial that focuses on preventing stroke recurrence in people with
small vessel ischemic stroke, or lacunes.
The overall purpose of the LIMITS study is to determine if serum levels of inflammatory
markers—such as hsCRP, serum amyloid A (SAA), CD40 ligand (CD40L), and monocyte
chemoattractant protein-1 (MCP-1)—predict recurrent stroke and other vascular events among
people with a history of small artery ischemic stroke. The project will also determine if
these markers predict which people will respond best to dual antiplatelet therapy with
clopidogrel and aspirin.
The specific aims of LIMITS are to determine if hsCRP, SAA, CD40L, and MCP-1 levels are
independent risk factors for recurrent ischemic stroke, and for recurrent ischemic stroke,
myocardial infarction, and death in participants in the SPS3 trial after adjusting for
demographic and traditional stroke risk factors, and other treatments, using a prospective
cohort of people with small subcortical strokes from the SPS3 trial. LIMITS also aims to
compare the efficacy of dual versus single antiplatelet therapy among participant groups with
and without elevated baseline inflammatory marker levels for the outcome of a.) recurrent
stroke, and b.) recurrent ischemic stroke, myocardial infarction, or death.
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