Randomized controlled trials stroke

Sherman DG, Atkinson RR Chippendale T, Levin KA, Ng K, Futrell N, Hsu CY, Levy DE. Intravenous ancrod fortreatment of acute ischemic stroke The STAT study A randomized controlled trial. Stroke Treatment with Ancrod Trial. JAMA. 2000 283 2395-2403. 

Leonardi-Bee J, Bath PM, BousserMG, et al. Dipyridamole for preventing recurrent ischemic stroke and other vascular events a meta-analysis of individual patient data from randomized controlled trials. Stroke. 2005 36 162-168. 

Indredavik B, Bakke F, Solberg R et al (1992) Benefit of a stroke unit. A randomized controlled trial. Stroke 22 1026-1031... 

Clark WM, Wissman S, Albers GW, Jhamandas JH, Madden KP, Hamilton S. Recombinant tissue-type plasminogen activator (Alteplase) for ischemic stroke 3 to 5 hours after symptom onset. The ATLANTIS Study a randomized controlled trial. Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke. JAMA 1999 282 2019-2026 [see comment]. 

TABLE 3.1 Large Randomized Controlled Trials of Intravenous Thrombolysis for Acute Ischemic Stroke. 

Furlan A, Higashida R, Wechsler L, Gent M, Rowley H, Kase C, Pessin M, Ahuja A, Callahan F, Clark WM, Silver F, Rivera F. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA 1999 282 2003-2011. 

Wahlgren NG, Ranasinha KW, Rosolacci T, Eranke CL, van Erven PM, Ashwood T, Claesson L. Clomethiazole acute stroke study (class) results of a randomized, controlled trial of clomethiazole versus placebo in 1360 acute stroke patients. Stroke 1999 30 21-28. 

Tseng MY, Czosnyka M, Richards H, Pickard JD, Kirkpatrick PJ. Effects of acute treatment with pravastatin on cerebral vasospasm, autoregulation, and delayed ischemic deficits after aneurysmal subarachnoid hemorrhage a phase II randomized placebo-controlled trial. Stroke 2005 36 1627-1632. 

Acute anticoagulation is widely used in the acute setting of arterial dissection. Once again, the rationale is to prevent propagation of local thrombosis and formation of new thrombus at the site of the injured arterial wall, which is beheved to reduce the likelihood of early stroke recurrence. This practice, while rational, is based on anecdotal evidence and case series, as randomized controlled trials have... 

The Publication Committee for the Trial of ORG 10171 in Acute Stroke Treatment (TOAST) Investigators. Low molecular weight heparinoid ORG 10172 (Danaparoid), and outcome after acute ischemic stroke a randomized controlled trial. JAMA 1998 279(16) 1265-1272. 

Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials. Arch Intern Med 1994 154 1449-1457. 

Streptokinase is not indicated for use in acute ischemic stroke treatment. Three large randomized controlled trials evaluating streptokinase were stopped early due to a high incidence of hemorrhage in the streptokinase-treated patients.14-16 At the present time, there is no indication for the use of streptokinase or thrombolytics other than alteplase in the acute treatment of ischemic stroke. 

Low-molecular-weight heparins and heparinoids are not recommended in the treatment of acute ischemic stroke.11 A meta-analysis was performed using data from 10 randomized controlled trials.19 A non-significant decrease in combined death and disability and a non-significant increase in case fatality and hemorrhage were seen. A reduction in venous thromboembolic events was observed in acute stroke patients however, there was also an increase in extracranial bleeding. 

Sato, Y., Iwamoto, J., Kanoko, T., and Satoh, K. (2005). Low-dose vitamin D prevents muscular atrophy and reduces falls and hip fractures in women after stroke A randomized controlled trial. Cerebrovasc. Dis. 20,187-192. 

Previous randomized controlled trials of diuretic- or -blocker-based regimens, involving a total of about 47,000 patients with hypertension, have collectively demonstrated that, over an average of about 5 years, such treatment produced much of the epidemiologi-cally expected benefit of the achieved BP reductions. A net reduction of 5-6 mmHg in usual DBP was associated with a 38% reduction in stroke risk and a 16% reduction in coronary heart disease (CHD) risk, with similar effects on fatal and non-fatal events. 

Albers G. W., Goldstein L. B., Hall D., and Lesko L. M. (2001). Aptiganel hydrochloride in acute ischemic stroke a randomized controlled trial. J. Am. Med. Assoc. 286 2673-2682. 

IboleJF etal. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. JAMA 2004 291 (5) 565-575. 

In order to understand the clinical management of transient ischemic attacks (TIAs) and stroke, to plan clinical services or to design randomized controlled trials, and to measure the overall impact of treatments, it is important to understand the epidemiology of stroke. 

Communities (ARIC) Study. Journal of the American Medical Association 279 119-124 Huxley R, Lewington S, Clarke R (2002). Cholesterol, coronary heart disease and stroke a review of puhhshed evidence from observational studies and randomized controlled trials. Seminars in Vascular Medicine 2 315-323... 

A total of 60 eligible papers were identified 22 were observational studies of patients receiving specific treatment 32 were observational studies, not based on specific treatments 6 were randomized controlled trials. No studies adhered to all six methodological principles. When the principles were relaxed to include only an inception cohort with adequate reporting and analysis of censored patients and appropriate endpoints, only two reports met these criteria, both from the Oxfordshire Community Stroke Project (OCSP 184 patients, follow-up over 3.7 years) (Dennis et al. 1989, 1990). 

Table 18.2. The relationship between aspirin dose and the risk of stroke and death within 30 days of carotid endarterectomy in a non-randomized comparison within the North American Symptomatic Carotid Endarterectomy Trial (Barnett et al. 1998) and in a subsequent randomized controlled trial (Taylor et al. 1999)...

Ali K, Roffe C, Crome P (2006). What patients want consumer involvement in the design of a randomized controlled trial of routine oxygen supplementation after acute stroke. Stroke 37 865-871... 

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