Kyung-Ho Yu1, Keun-Sik Hong2, Mi-Sun Oh1, Juneyoung Lee3, Ji Sung Lee4, Sun U Kwon5. 1. Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Chunchon, Republic of Korea. 2. Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea. 3. Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea. 4. Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea. 5. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: sukwon@amc.seoul.kr.
Abstract
GOAL: Cognitive impairment and dementia are common disabilities after stroke and are associated with increased risks of mortality and recurrent stroke. The prevention of dementia and preserving cognitive function are also important in stroke patients, but its strategy is not established yet. This PICASSO-COG (PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage for reducing COGnitive decline) substudy aims to assess the effects of cilostazol and/or probucol on cognitive function. MATERIALS AND METHODS: The substudy aims to assess the reduction in cognitive decline of patients treated with cilostazol and/or probucol in the PICASSO trial. Patients will be assessed using the Korean version of mini-mental state examination and Montreal Cognitive Assessment at 4, 7, 10, 13, 25, 37, and 49 months after randomization. The primary outcome is the change in mini-mental status examination score, compared between treatment groups, with a modified intention-to-treat population using a restricted maximum likelihood-based mixed effects model repeat measurement. This will allow a within-subject correlation due to repeated cognitive tests as well as a different number of measurements among subjects at baseline and each follow-up period. CONCLUSION: PICASSO-COG is a novel study for assessing the effect on cognitive function of different antiplatelet regimens and the addition of a nonstatin lipid-lowering agent to the current standard statin therapy in patients who have a recent ischemic lesion and prior intracerebral macro- or microbleeds.
RCT Entities:
GOAL: Cognitive impairment and dementia are common disabilities after stroke and are associated with increased risks of mortality and recurrent stroke. The prevention of dementia and preserving cognitive function are also important in strokepatients, but its strategy is not established yet. This PICASSO-COG (PreventIon of CArdiovascular events in iSchemic Strokepatients with high risk of cerebral hemOrrhage for reducing COGnitive decline) substudy aims to assess the effects of cilostazol and/or probucol on cognitive function. MATERIALS AND METHODS: The substudy aims to assess the reduction in cognitive decline of patients treated with cilostazol and/or probucol in the PICASSO trial. Patients will be assessed using the Korean version of mini-mental state examination and Montreal Cognitive Assessment at 4, 7, 10, 13, 25, 37, and 49 months after randomization. The primary outcome is the change in mini-mental status examination score, compared between treatment groups, with a modified intention-to-treat population using a restricted maximum likelihood-based mixed effects model repeat measurement. This will allow a within-subject correlation due to repeated cognitive tests as well as a different number of measurements among subjects at baseline and each follow-up period. CONCLUSION:PICASSO-COG is a novel study for assessing the effect on cognitive function of different antiplatelet regimens and the addition of a nonstatin lipid-lowering agent to the current standard statin therapy in patients who have a recent ischemic lesion and prior intracerebral macro- or microbleeds.
Authors: Joseph Kwan; Melanie Hafdi; Lorraine L W Chiang; Phyo K Myint; Li Siang Wong; Terry J Quinn Journal: Cochrane Database Syst Rev Date: 2022-07-14
Authors: Peter Alexander; Shakthi Visagan; Sara Jawhar; Amogh Kare; Noor Issa; Reem Issa; Abbas Jawhar; Sneha Thomas; Vasavi Gorantla Journal: J Aging Res Date: 2022-09-19