Stroke Clinical Trial
Official title:
Anglo-Scandinavian Cardiac Outcomes Trial: Post Trial Follow-Up Study
ASCOT-10 is a follow-up study of surviving participants in the United Kingdom (UK)arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) which was conducted between 2000 and 2005.ASCOT's results showed substantial cardiovascular benefit from: 1) the use of a cholesterol lowering drug (atorvastatin) compared to placebo, and 2) the use of a blood-pressure lowering strategy based on amlodipine when compared to a strategy based on atenolol. ASCOT-10 will test the hypothesis that the ASCOT subjects who originally received Atorvastatin and those who received amlodipine based treatment will continue to show a cardiovascular benefit relative to those who did not, even though all the subjects have had access to optimal treatment in the interim.
Study investigators will have access to information about ASCOT patients from their study
centre who have died since the end of the ASCOT study in 2005. Of the 8580 ASCOT patients
from the United Kingdom, 7300 were flagged with The Information Centre for Health and Social
Care at the end of the trial in 2005.This flagging process was re-activated in 2010 so that
all deaths and incident cancers relating to these patients are now sent every three months to
the ASCOT-10 co-ordinating centre. These results are identified by the ASCOT study number,
with all personal data removed. These deceased patient numbers will be communicated to the
participating sites so that the trial centre staff will not contact their families.
An attempt will be made to contact all remaining patients from the participating UK ASCOT
sites.
Initial contact will be made via the general practitioner (GP) surgery. If the GP can provide
up-to-date contact details and feels that it is appropriate to contact the patient, patients
will then be sent an introductory letter, a patient information sheet, a consent form and a
health questionnaire.
They will be asked to complete a 'tick-box' form given the following options:
1. Willing to complete health questionnaire.
2. Willing for information about health to be given by GP or next of kin.
3. Willing to give information by telephone only.
4. Willing to attend study clinic for a single visit.
5. Not willing to take part.
They will be asked to complete this form, sign, date and return in a pre-paid envelope to
their trial centre. This form will be used as the consent form for the questionnaire part of
the study.
They will also be asked to complete a simple health questionnaire. This will collect
information on any health problems experienced since the end of the ASCOT trial (in
particular about heart attacks and strokes/mini-strokes), as well as information on any
hospital admissions during this period and current medication. In addition, information about
current weight, exercise, alcohol consumption, smoking and general quality of life will be
collected. Patients will be asked to return their completed questionnaire, along with their
consent/reply form, to their local trial centre.
If the study team have not received a response within four weeks, a further reminder letter
will be sent. If no response has been obtained after a further four weeks, a final attempt
will be made to contact the patient by letter or telephone call.
10% of the study population from each trial centre, who will be chosen at random, will be
invited to attend their trial centre for a single clinic visit. Further informed consent
following discussion with member(s) of the study team will be obtained. During the clinic
visit the questionnaire will be reviewed and several further measurements will be taken as
follows:
- Blood pressure
- Weight
- Pulse wave analysis. (This is a simple, non-invasive test, very much like a blood
pressure measurement, that gives us further information on the function of the heart and
arteries)
- Blood for creatinine and estimated glomerular filtration rate(eGFR)(tests of kidney
function), electrolytes (sodium and potassium), fasting lipids (cholesterol), fasting
glucose, glycated haemoglobin (a further test for diabetes) An additional blood test
will be taken and plasma stored for the later analysis of chemicals in the blood which
might predict cardiovascular risk. Precise details of this further testing are not
currently available. However, the plasma will be stored securely and no identifiable
data will be present on the samples (i.e. they will be stored anonymously, identified
only by the subject's study number).
Every effort will be taken to contact patients who have moved since the ASCOT study closed
and for whom no contact details are available. This may be done by health service tracking
services, where available, or via Primary Care Trusts (PCTs).
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