Clinical Features and Racial/Ethnic Differences Among the 3020 Participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial

Carole L White; Jeff M Szychowski; Ana Roldan; Marie-France Benavente; Edwin J Pretell; Oscar H Del Brutto; Carlos S Kase; Antonio Arauz; Brett C Meyer; Irene Meissner; Bart M Demaerschalk; Leslie A McClure; Christopher S Coffey; Lesly A Pearce; Robin Conwit; Lisa H Irby; Kalyani Peri; Pablo E Pergola; Robert G Hart; Oscar R Benavente; SPS3 Investigators

doi:10.1016/j.jstrokecerebrovasdis.2012.03.002

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Clinical Features and Racial/Ethnic Differences Among the 3020 Participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial

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Clinical Features and Racial/Ethnic Differences Among the 3020 Participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial

Carole L White, Jeff M Szychowski, Ana Roldan, Marie-France Benavente, Edwin J Pretell, Oscar H Del Brutto, Carlos S Kase, Antonio Arauz, Brett C Meyer, Irene Meissner, …

Journal of stroke and cerebrovascular diseases, Vol.22(6), pp.764-774

08/2013

DOI: 10.1016/j.jstrokecerebrovasdis.2012.03.002

PMCID: PMC3970545

PMID: 22516427

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https://www.ncbi.nlm.nih.gov/pmc/articles/3970545View

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Abstract

This study examined the baseline characteristics, racial/ethnic differences, and geographic differences among participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) study. The SPS3 trial enrolled patients who experienced a symptomatic small subcortical stroke (lacunar stroke) within the previous 6 months and an eligible lesion on detected on magnetic resonance imaging. The patients were randomized, in a factorial design, to antiplatelet therapy (aspirin 325 mg daily plus clopidogrel 75 mg daily vs aspirin 325 mg daily plus placebo) and to one of two levels of systolic blood pressure targets (“intensive” [<130 mmHg] or “usual” [130-149 mmHg]). A total of 3020 participants were recruited from 81 clinical sites in 8 countries. In this cohort, the mean age was 63 years, 63% were men, 75% had a history of hypertension, and 37% had diabetes. The racial distribution was 51% white, 30% Hispanic, and 16% black. Compared with white subjects, black subjects were younger (mean age, 58 years vs 64 years; P <.001) and had a higher prevalence of hypertension (87% vs 70%; P <.001). The prevalence of diabetes was higher in the Hispanic and black subjects compared with the white subjects (42% and 40% vs 32%; both P <.001). Tobacco smoking at the time of qualifying stroke was much more frequent in the Spanish participants than in subjects from North America and from Latin America (32%, 22%, and 9%, respectively; P <.001). Mean systolic blood pressure at study entry was 4 mmHg lower in the Spanish subjects compared with the North American subjects (P <.01). The SPS3 cohort is the largest magnetic resonance imaging–defined series of patients with S3. Among the racially/ethnically diverse SPS3 participants, important differences in patient features and vascular risk factors could influence prognosis for recurrent stroke and response to interventions.

clinical trial

Lacunar

blood pressure

small vessel disease

cognition

antiplatelet

prevention

Details

Title: Subtitle: Clinical Features and Racial/Ethnic Differences Among the 3020 Participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial
Creators: Carole L White - School of Nursing, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas
Jeff M Szychowski - Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
Ana Roldan - Division of Neurology, Department of Medicine, Brain Research Center, University of British Columbia, Vancouver, Canada
Marie-France Benavente - Division of Neurology, Department of Medicine, Brain Research Center, University of British Columbia, Vancouver, Canada
Edwin J Pretell - Hospital Alberto Sabogal, Lima, Peru
Oscar H Del Brutto - Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador
Carlos S Kase - Department of Neurology, Boston Medical Center, Boston, Massachusetts
Antonio Arauz - Stroke Clinic, Instituto Nacional de Neurologia y Neurocirugía Manuel Velasco, Suárez, Mexico
Brett C Meyer - Department of Neurosciences at UCSD, University of California, San Diego, California
Irene Meissner - Department of Neurology, Mayo Clinic, Rochester, Minnesota
Bart M Demaerschalk - Division of Cerebrovascular Diseases, Department of Neurology, Mayo Clinic, Phoenix, Arizona
Leslie A McClure - Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
Christopher S Coffey - Department of Biostatistics, University of Iowa, Iowa City, Iowa
Lesly A Pearce - Biostatistician Consultant, Bel Air Court, Minot, North Dakota
Robin Conwit - Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
Lisa H Irby - Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
Kalyani Peri - Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
Pablo E Pergola - Department of Neurology, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas
Robert G Hart - Population Health Research Institute, McMaster University, Hamilton, Canada
Oscar R Benavente - Division of Neurology, Department of Medicine, Brain Research Center, University of British Columbia, Vancouver, Canada
SPS3 Investigators
Resource Type: Journal article
Publication Details: Journal of stroke and cerebrovascular diseases, Vol.22(6), pp.764-774
DOI: 10.1016/j.jstrokecerebrovasdis.2012.03.002
PMID: 22516427
PMCID: PMC3970545
NLM abbreviation: J Stroke Cerebrovasc Dis
ISSN: 1052-3057
eISSN: 1532-8511
Publisher: Elsevier Inc
Grant note: 2U01 NS38529-04A1 / National Institute of Neurological Disorders and Stroke
Language: English
Date published: 08/2013
Academic Unit: Biostatistics
Record Identifier: 9983997362602771

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