Transient Ischemic Attack Clinical Trial
Official title:
Integrated Care Improves Risk-factor Modification After Transient Ischemic Attack or Minor Stroke Patients (Lleida TIA Intervention Study)
Having a transient ischemic attack (TIA) or a minor stroke is a real risk factor not only for
early recurrent stroke but also for major extracranial vascular events. Despite these warning
events provide an opportunity for prevention usual post-discharge care of these subjects
(mainly at primary care) is not associated with an optimal control of cerebrovascular risk
factors (CRF). The investigators hypothesized that patients exposed to the intensified
integrated multifactorial interventional care program (ICP) model would exhibit better
management of CRF and receive more targeted advice than patients receiving standard care. A
second objective was to investigate the effect of the ICP model on stroke recurrence or the
appearance of major extracranial vascular events.
To test this hypothesis the investigators perform a controlled, randomized, single blind,
parallel trial. Subjects are recruited at the Stroke Unit and are randomized into two groups:
1. usual care (control group) and 2. ICP (intervention group). Patients assigned to receive
usual care (general practitioner with the possibility of being referred to specialists) are
compared to those assigned to undergo ICP. This ICP involves strict treatment goals
(LDL-cholesterol <100 mg/dl, blood pressure <130/80 mmHg, HbA1c<7%, no smoking, regular
exercise and no excessive alcohol consumption) to be achieved through behavior modification
(diet, physical activity, smoking cessation, alcohol cessation) and a stepwise introduction
of pharmacologic therapy for the main CRF (hypercholesterolemia, hypertension and diabetes).
This multifactorial intervention is overseen in each primary care center by a trained general
practitioner and nursery. The treatment goals are the same for the control group and the
intervention group. General practitioners caring patients of each group are informed of these
strict treatment goals. Patients in the ICP group receive a minimum of four scheduled
individual consultations in one year (baseline, 3, 6 and 9 months). Primary and secondary
outcomes are evaluated by an external Neurologist at 12 months after their inclusion.
n/a
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