Ignite Creation Date:
2024-05-06 @ 2:26 AM
Last Modification Date:
2024-10-26 @ 11:18 AM
Study NCT ID:
NCT02046460
Status:
COMPLETED
Last Update Posted:
2024-05-21
First Post:
2014-01-23
Brief Title:
Biomarkers and Antithrombotic Treatment in Cervical Artery Dissection - TREAT-CAD
Sponsor:
Stefan Engelter
Organization:
University Hospital Basel Switzerland
Study Overview
Official Title:
Biomarkers and Antithrombotic Treatment in Cervical Artery Dissection - TREAT-CAD
Status:
COMPLETED
Status Verified Date:
2024-05
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
TREAT-CAD
Brief Summary:
Primary objective To demonstrate the non-inferiority of acetylsalicylic acid ASA to anticoagulant treatment vitamin K antagonists in CAD-patients with regard to outcome and complication measures
Methods Randomized controlled open labeled multicenter non-inferiority trial with blinded assessment of outcome events
Primary endpoint Primary composite outcome measure - labeled Cerebrovascular Ischemia major Hemorrhagic events or Death CIHD - includes the following efficacy and safety outcome measures during the treatment period i occurrence of any stroke new acute lesions on diffusion weighted MRI ii any major extracranial hemorrhage any symptomatic intracranial hemorrhage and any asymptomatic micro- or macrobleeds iii death
Methods Randomized controlled open labeled multicenter non-inferiority trial with blinded assessment of outcome events
Primary endpoint Primary composite outcome measure - labeled Cerebrovascular Ischemia major Hemorrhagic events or Death CIHD - includes the following efficacy and safety outcome measures during the treatment period i occurrence of any stroke new acute lesions on diffusion weighted MRI ii any major extracranial hemorrhage any symptomatic intracranial hemorrhage and any asymptomatic micro- or macrobleeds iii death
Detailed Description:
Substudies
1 In-depth analysis of the TREAT-CAD randomized trial
The investigators will perform a subgroup analysis on the per-protocol population investigating if the antithrombotic treatment effect anticoagulation versus aspirin depends on specific patient baseline characteristics The investigators will look at the following subgroups Presenting with cerebral ischemia - either clinical ischemic events MRI lesions or both - versus presenting with local symptoms only occlusion of the dissected artery at baseline noyes early versus delayed treatment start divided by the median of the study population acute recanalization therapy including intravenous thrombolysis andor endovascular therapy noyes intracranial extension of the dissected artery noyes site of dissection defined as internal carotid artery dissection versus vertebral artery dissection single versus multivessel dissection younger versus older age divided by the median of the study population and male versus female
2 TCD Monitoring Substudy
The objective of the TREAT-CAD transcranial Doppler TCD substudy is to i detect the frequency of microembolic signals MES in CAD patients stratified to the type of treatment aspirin vs anticoagulation - in the setting of an RCT randomized controlled trial- and ii to evaluate the meaning of MES by addressing the following questions a Is there an association of MES presence or number with the occurrence of clinical andor surrogate MR magnetic resonance outcome measures b Is there an interaction between MES type of treatment and outcome events Participants are asked to allow a 6-h TCD monitoring in between day 1 and day 4 since start of the allocated study treatment Recordings were allowed to be split in up to three episodes 2 h each In patients with ICAD internal carotid artery dissection the ipsilateral middle cerebral artery is investigated In patients with VAD vertebral artery dissection the ipsilateral posterior cerebral artery is investigated
3 Biomarker substudy
The objective of the biomarker study is to investigate whether the plasma level of MMP9 matrix-metalloproteinase 9 and the ratio of the plasma MMP9 to TIMP2 tissue inhibitor of metalloproteinases 2 is associated with efficacy and safety measures in CAD patients when stratified to the allocated treatment regime Plasma samples are collected from participants at baseline ie prior to start of the allocated treatment within the TREAT-CAD main study and at Follow-up visit 1 The specific focus on MMP9 and TIMP2 is based on preliminary observational data pointing to higher MMP9 and MMP9TIMP2 ratios in CAD versus control patients
4 6 Month-follow-up for TREAT-CAD To compare i the frequency of clinical and MRI outcomes 6 months after cervical artery dissection among the per-protocol participants of the TREAT-CAD trial and ii to focus on events occurring between 3 and 6 months stratified to the type of antithrombotic medication taken as-treated analysis
5 Detailed imaging analysis in the TREAT-CAD study To identify possible imaging risk factors for recurrent stroke and to evaluate the dependence of antithromobotic therapy on imaging factors
1 In-depth analysis of the TREAT-CAD randomized trial
The investigators will perform a subgroup analysis on the per-protocol population investigating if the antithrombotic treatment effect anticoagulation versus aspirin depends on specific patient baseline characteristics The investigators will look at the following subgroups Presenting with cerebral ischemia - either clinical ischemic events MRI lesions or both - versus presenting with local symptoms only occlusion of the dissected artery at baseline noyes early versus delayed treatment start divided by the median of the study population acute recanalization therapy including intravenous thrombolysis andor endovascular therapy noyes intracranial extension of the dissected artery noyes site of dissection defined as internal carotid artery dissection versus vertebral artery dissection single versus multivessel dissection younger versus older age divided by the median of the study population and male versus female
2 TCD Monitoring Substudy
The objective of the TREAT-CAD transcranial Doppler TCD substudy is to i detect the frequency of microembolic signals MES in CAD patients stratified to the type of treatment aspirin vs anticoagulation - in the setting of an RCT randomized controlled trial- and ii to evaluate the meaning of MES by addressing the following questions a Is there an association of MES presence or number with the occurrence of clinical andor surrogate MR magnetic resonance outcome measures b Is there an interaction between MES type of treatment and outcome events Participants are asked to allow a 6-h TCD monitoring in between day 1 and day 4 since start of the allocated study treatment Recordings were allowed to be split in up to three episodes 2 h each In patients with ICAD internal carotid artery dissection the ipsilateral middle cerebral artery is investigated In patients with VAD vertebral artery dissection the ipsilateral posterior cerebral artery is investigated
3 Biomarker substudy
The objective of the biomarker study is to investigate whether the plasma level of MMP9 matrix-metalloproteinase 9 and the ratio of the plasma MMP9 to TIMP2 tissue inhibitor of metalloproteinases 2 is associated with efficacy and safety measures in CAD patients when stratified to the allocated treatment regime Plasma samples are collected from participants at baseline ie prior to start of the allocated treatment within the TREAT-CAD main study and at Follow-up visit 1 The specific focus on MMP9 and TIMP2 is based on preliminary observational data pointing to higher MMP9 and MMP9TIMP2 ratios in CAD versus control patients
4 6 Month-follow-up for TREAT-CAD To compare i the frequency of clinical and MRI outcomes 6 months after cervical artery dissection among the per-protocol participants of the TREAT-CAD trial and ii to focus on events occurring between 3 and 6 months stratified to the type of antithrombotic medication taken as-treated analysis
5 Detailed imaging analysis in the TREAT-CAD study To identify possible imaging risk factors for recurrent stroke and to evaluate the dependence of antithromobotic therapy on imaging factors
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None