Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST).
View / Open Files
Authors
Scutt, Polly
Blackburn, Dan
Krishnan, Kailash
Ballard, Clive
Burns, Alistair
Ford, Gary A
Passmore, Peter
Pocock, Stuart
Reckless, John
Sprigg, Nikola
Stewart, Rob
Wardlaw, Joanna M
Bath, Philip M
Publication Date
2015-11-07Journal Title
Trials
ISSN
1745-6215
Publisher
Springer Science and Business Media LLC
Volume
16
Pages
509
Language
eng
Type
Article
This Version
VoR
Physical Medium
Electronic
Metadata
Show full item recordCitation
Scutt, P., Blackburn, D., Krishnan, K., Ballard, C., Burns, A., Ford, G. A., Mant, J., et al. (2015). Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST).. Trials, 16 509. https://doi.org/10.1186/s13063-015-1033-2
Abstract
BACKGROUND: A common complication after stroke is development of cognitive impairment and dementia. However, effective strategies for reducing the risk of developing these problems remain undefined. Potential strategies include intensive lowering of blood pressure (BP) and/or lipids. This paper summarises the baseline characteristics, statistical analysis plan and feasibility of a randomised control trial of blood pressure and lipid lowering in patients post-stroke with the primary objective of reducing cognitive impairment and dementia. METHODS: The Prevention Of Decline in Cognition After Stroke Trial (PODCAST) was a multi-centre prospective randomised open-label blinded-endpoint controlled partial-factorial internal pilot trial running in secondary and primary care. Participants without dementia were enrolled 3-7 months post ischaemic stroke or spontaneous intracerebral haemorrhage, and randomised to intensive versus guideline BP lowering (target systolic BP <125 mmHg versus <140 mmHg); patients with ischaemic stroke were also randomised to intensive or guideline lipid lowering (target LDL cholesterol <1.4 mmol/L versus <3 mmol/L). The primary outcome was the Addenbrooke's Cognitive Examination-Revised; a key secondary outcome was to assess feasibility of performing a large trial of one or both interventions. Data are number (%) or mean (standard deviation). The trial was planned to last for 8 years with follow-up between 1 and 8 years. The plan for reporting the main results is included as Additional file 2. RESULTS: 83 patients (of a planned 600) were recruited from 19 UK sites between 7 October 2010 and 31 January 2014. Delays, due to difficulties in the provision of excess treatment costs and to complexity of follow-up, led to few centres taking part and a much lower recruitment rate than planned. Patient characteristics at baseline were: age 74 (SD 7) years, male 64 (77 %), index stroke ischaemic 77 (93 %), stroke onset to randomisation 4.5 [SD 1.3] months, Addenbrooke's Cognitive Examination-Revised 86 (of 100, SD 8), Montreal Cognitive Assessment 24 (of 30, SD 3), BP 147/82 (SD 19/11) mmHg, total cholesterol 4.0 (SD 0.8) mmol/L and LDL cholesterol 2.0 (SD 0.7) mmol/L, modified Rankin Scale 1.1 (SD 0.8). CONCLUSION: Limited recruitment suggests that a large trial is not feasible using the current protocol. The effects of the interventions on BP, lipids, and cognition will be reported in the main publication. TRIAL REGISTRATION: ISRCTN85562386 registered on 23 September 2009.
Keywords
Humans, Dementia, Antihypertensive Agents, Treatment Outcome, Clinical Protocols, Prospective Studies, Feasibility Studies, Pilot Projects, Sample Size, Cognition, Cognition Disorders, Neuropsychological Tests, Blood Pressure, Patient Selection, Time Factors, Aged, Aged, 80 and over, Female, Male, Cholesterol, LDL, Stroke, Hypolipidemic Agents, Biomarkers, United Kingdom, Stroke Rehabilitation
Identifiers
External DOI: https://doi.org/10.1186/s13063-015-1033-2
This record's URL: https://www.repository.cam.ac.uk/handle/1810/275459
Statistics
Total file downloads (since January 2020). For more information on metrics see the
IRUS guide.
Recommended or similar items
The following licence files are associated with this item: