Category: Neurology

LEAP trial (2019): Early vs Delayed Levodopa in Parkinson’s Disease

LEAP Trial Summary: The LEAP trial was a Multicenter, randomized, double-blind, placebo-controlled, delayed-start trial that randomized 445 patients with Parkinson’s disease (mean age 65) and similar baseline clinical characteristics to early-start group (levodopa + cardbidopa for 80 weeks) (n=222) or delayed-start group (Placebo for 40 wks then levodopa + cardbidopa for 40 weeks) (n=223). The..

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CHANCE Trial (2013): Clopidogrel with aspirin in acute minor stroke or transient ischemic attack

CHANCE Trial Summary: Wang et al. randomized 5,170 patients (≥40 years) with either minor ischemic stroke (NIHSS score ≤3) or high-risk TIA (ABCD2 score ≥4) to either aspirin/clopidogrel combination or aspirin alone. The primary objective was to assess if early administration of aspirin/clopidogrel reduces rates of subsequent strokes when compared to aspirin monotherapy in patients..

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BRIDGE Trial (2015): Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation

BRIDGE Trial Summary: Douketis JD et al. randomized 1,884 patients on warfarin (INR 2-3 for ≥3m) with AF or A-flutter and CHADS2 Score ≥1 to LMWH: dalteparin (100 IU/kg BID) or placebo. The objective was to assess if bridging anticoagulation reduce rates of arterial thromboembolism compared to no bridging in patients with atrial fibrillation undergoing..

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POINT Trial (2018): Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA

POINT Trial Summary: Johnston et al. randomized 4,881 patients who presented with low risk stroke or high risk TIA to either a combination of aspirin and clopidogrel or aspirin alone. Their objective was to assess the efficacy of dual antiplatelet therapy on recurrence of stroke, MI or mortality associated with ischemia. The results of POINT..

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RESPECT Trial (2013): Closure of PFO versus Medical Therapy after Cryptogenic Stroke

2013, Closure of Patent Foramen Ovale versus Medical Therapy after Cryptogenic Stroke, NEJM RESPECT Trial Key Points: Patients with cryptogenic stroke have higher incidence of PFO compared to general population. This led to the concept that closing PFO might be beneficial in terms of preventing recurrence of stroke in this population. The initial CLOSURE I trial showed no..

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DEFUSE-3 Trial (2018): Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging

DEFUSE-3 Trial Summary: Gregory W et al. randomized 182 patients with proximal middle-cerebral-artery or internal carotid artery occlusion, an initial infarct size of <70 ml, and a ratio of the volume of ischemic tissue to infarct volume ≥ 1.8 to either thrombectomy endovascular therapy group (n=92) or medical therapy group (n=90). The primary objective was..

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