- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT05047172
Porównanie terapii przeciwzakrzepowych i przeciwpłytkowych w miażdżycy tętnic wewnątrzczaszkowych (CAPTIVA)
Porównanie terapii przeciwzakrzepowych i przeciwpłytkowych w leczeniu miażdżycy naczyń wewnątrzczaszkowych (CAPTIVA)
The primary goal of the trial is to determine if the experimental arms (rivaroxaban or ticagrelor or both) are superior to the clopidogrel arm for lowering the 1-year rate of ischemic stroke, intracerebral hemorrhage, or vascular death.
Przegląd badań
Status
Szczegółowy opis
The proposed study is relevant to public health because narrowing of brain arteries is one of the most common causes of stroke worldwide. Compelling evidence suggests novel antithrombotic medications could reduce the rate of stroke in patients with narrowed brain arteries. The proposed study will directly compare novel antithrombotic medications to standard care antiplatelet medications for preventing stroke and death from vascular causes in patients with narrowed brain arteries.
Typ studiów
Zapisy (Szacowany)
Faza
- Faza 3
Kontakty i lokalizacje
Lokalizacje studiów
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Alabama
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Birmingham, Alabama, Stany Zjednoczone, 35233
- University of Alabama Hospital
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Mobile, Alabama, Stany Zjednoczone, 36604
- University of South Alabama University Hospital
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Arizona
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Phoenix, Arizona, Stany Zjednoczone, 85013
- St. Joseph's Hospital and Medical Center
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California
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Carmichael, California, Stany Zjednoczone, 95608
- Mercy San Juan Medical Center
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Chula Vista, California, Stany Zjednoczone, 91910
- The Neuron Clinic - Chula Vista
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Fontana, California, Stany Zjednoczone, 92335
- Kaiser Permanente Fontana Medical Center
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Long Beach, California, Stany Zjednoczone, 90806
- Long Beach Memorial Medical Center
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Los Alamitos, California, Stany Zjednoczone, 90720
- Los Alamitos Medical Center
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Los Angeles, California, Stany Zjednoczone, 90027
- Kaiser Permanente Los Angeles Medical Center
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Los Angeles, California, Stany Zjednoczone, 90095
- Ronald Reagan UCLA Medical Center, Los Angeles, CA
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Orange, California, Stany Zjednoczone, 92868
- UC Irvine Medical Center
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Sacramento, California, Stany Zjednoczone, 95817
- UC Davis Medical Center
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Salinas, California, Stany Zjednoczone, 93901
- Salinas Valley Memorial Hospital
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San Diego, California, Stany Zjednoczone, 92103
- UCSD Medical Center - Hillcrest Hospital
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Torrance, California, Stany Zjednoczone, 90503
- Providence Little Company of Mary Medical Center Torrance
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Colorado
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Aurora, Colorado, Stany Zjednoczone, 80045
- University of Colorado Hospital
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Grand Junction, Colorado, Stany Zjednoczone, 81501
- St. Mary's Medical Center
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Connecticut
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Hartford, Connecticut, Stany Zjednoczone, 06102
- Hartford Hospital
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New Haven, Connecticut, Stany Zjednoczone, 06520
- Yale New Haven Hospital
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District of Columbia
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Washington D.C., District of Columbia, Stany Zjednoczone, 20010
- MedStar Washington Hospital Center
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Florida
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Clearwater, Florida, Stany Zjednoczone, 33756
- Morton Plant Hospital
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Gainesville, Florida, Stany Zjednoczone, 32608
- UF Health Shands Hospital
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Jacksonville, Florida, Stany Zjednoczone, 32224
- Mayo Clinic
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Jacksonville, Florida, Stany Zjednoczone, 32207
- Baptist Medical Center Jacksonville
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Miami, Florida, Stany Zjednoczone, 33136
- Jackson Memorial Hospital
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Port Saint Lucie, Florida, Stany Zjednoczone, 34987
- Cleveland Clinic Tradition Hospital
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Tampa, Florida, Stany Zjednoczone, 33606
- Tampa General Hospital
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Georgia
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Atlanta, Georgia, Stany Zjednoczone, 30303
- Grady Memorial Hospital
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Atlanta, Georgia, Stany Zjednoczone, 30303
- Emory University Hospital
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Augusta, Georgia, Stany Zjednoczone, 30912
- Augusta University Medical Center
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Illinois
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Carbondale, Illinois, Stany Zjednoczone, 62901
- Memorial Hospital of Carbondale
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Chicago, Illinois, Stany Zjednoczone, 60612
- Rush University Medical Center
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Chicago, Illinois, Stany Zjednoczone, 60612
- University of Illinois Hospital
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Chicago, Illinois, Stany Zjednoczone, 60637
- University of Chicago Medical Center
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Evanston, Illinois, Stany Zjednoczone, 60201
- Evanston Hospital
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Oak Lawn, Illinois, Stany Zjednoczone, 60453
- Advocate Christ Medical Center
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Rockford, Illinois, Stany Zjednoczone, 61114
- Javon Bea Hospital - Riverside
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Kansas
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Kansas City, Kansas, Stany Zjednoczone, 66160
- University of Kansas Hospital
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Kentucky
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Lexington, Kentucky, Stany Zjednoczone, 40503
- Baptist Health Lexington
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Lexington, Kentucky, Stany Zjednoczone, 40536
- University of Kentucky Hospital
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Louisiana
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New Orleans, Louisiana, Stany Zjednoczone, 70121
- Ochsner Medical Center - Main Campus
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Maryland
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Baltimore, Maryland, Stany Zjednoczone, 21201
- University of Maryland Medical Center
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Massachusetts
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Boston, Massachusetts, Stany Zjednoczone, 02215
- Beth Israel Deaconess Medical Center
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Boston, Massachusetts, Stany Zjednoczone, 02115
- Brigham and Women's Hospital
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Boston, Massachusetts, Stany Zjednoczone, 02114
- Massachusetts General Hospital
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Boston, Massachusetts, Stany Zjednoczone, 02118
- Boston Medical Center
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Worcester, Massachusetts, Stany Zjednoczone, 01655
- UMass Memorial Medical Center
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Michigan
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Detroit, Michigan, Stany Zjednoczone, 48202
- Henry Ford Hospital
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Flint, Michigan, Stany Zjednoczone, 48532
- McLaren Flint
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Mount Clemens, Michigan, Stany Zjednoczone, 48043
- McLaren Macomb
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Wyoming, Michigan, Stany Zjednoczone, 49519
- Metro Health Hospital
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Minnesota
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Edina, Minnesota, Stany Zjednoczone, 55414
- M Health Fairview Southdale Hospital
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Minneapolis, Minnesota, Stany Zjednoczone, 55407
- Abbott Northwestern Hospital
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Minneapolis, Minnesota, Stany Zjednoczone, 55415
- M Health Fairview University of Minnesota Medical Center
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Mississippi
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Jackson, Mississippi, Stany Zjednoczone, 39216
- University of Mississippi Medical Center
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Missouri
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Columbia, Missouri, Stany Zjednoczone, 65212
- University of Missouri Health Care
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St Louis, Missouri, Stany Zjednoczone, 62269
- Barnes Jewish Hospital
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Nebraska
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Omaha, Nebraska, Stany Zjednoczone, 68198
- University of Nebraska Medical Center
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New Jersey
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Camden, New Jersey, Stany Zjednoczone, 08103
- Cooper University Hospital
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Neptune City, New Jersey, Stany Zjednoczone, 07753
- Jersey Shore University Medical Center
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Ridgewood, New Jersey, Stany Zjednoczone, 07450
- Valley Hospital
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New Mexico
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Albuquerque, New Mexico, Stany Zjednoczone, 87106
- University of New Mexico Hospital
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New York
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Brooklyn, New York, Stany Zjednoczone, 11203
- SUNY Downstate Medical Center
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Brooklyn, New York, Stany Zjednoczone, 11203
- Kings County Hospital Center
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Brooklyn, New York, Stany Zjednoczone, 11220
- NYU Langone Hospital - Brooklyn
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Buffalo, New York, Stany Zjednoczone, 14202
- Buffalo General Medical Center
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Lake Success, New York, Stany Zjednoczone, 11042
- North Shore University Hospital
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New York, New York, Stany Zjednoczone, 10029
- The Mount Sinai Hospital
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New York, New York, Stany Zjednoczone, 10021
- NYP Weill Cornell Medical Center
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New York, New York, Stany Zjednoczone, 10032
- NYP Columbia University Medical Center
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Rochester, New York, Stany Zjednoczone, 14642
- Strong Memorial Hospital
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The Bronx, New York, Stany Zjednoczone, 10467
- Montefiore Medical Center
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North Carolina
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Charlotte, North Carolina, Stany Zjednoczone, 28207
- Carolinas Medical Center
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Durham, North Carolina, Stany Zjednoczone, 27710
- Duke University Hospital
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Greensboro, North Carolina, Stany Zjednoczone, 27405
- Moses H. Cone Memorial Hospital
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Greenville, North Carolina, Stany Zjednoczone, 27834
- ECU Health Medical Center
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Winston-Salem, North Carolina, Stany Zjednoczone, 27157
- Wake Forest Baptist Medical Center
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Ohio
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Akron, Ohio, Stany Zjednoczone, 44307
- Cleveland Clinic Akron General
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Cincinnati, Ohio, Stany Zjednoczone, 45267
- University of Cincinnati Medical Center
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Cincinnati, Ohio, Stany Zjednoczone, 45220
- Good Samaritan Hospital
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Cleveland, Ohio, Stany Zjednoczone, 44195
- Cleveland Clinic
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Cleveland, Ohio, Stany Zjednoczone, 44106
- UH Cleveland Medical Center
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Columbus, Ohio, Stany Zjednoczone, 43210
- OSU Wexner Medical Center
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Toledo, Ohio, Stany Zjednoczone, 43608
- Mercy St. Vincent Medical Center
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Toledo, Ohio, Stany Zjednoczone, 43606
- Toledo Hospital
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Oklahoma
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Oklahoma City, Oklahoma, Stany Zjednoczone, 73104
- OU Medical Center
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Oregon
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Portland, Oregon, Stany Zjednoczone, 97225
- Providence St. Vincent Medical Center
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Portland, Oregon, Stany Zjednoczone, 97239
- Oregon Health & Science University Hospital
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Pennsylvania
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Abington, Pennsylvania, Stany Zjednoczone, 19001
- Jefferson Abington Hospital
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Altoona, Pennsylvania, Stany Zjednoczone, 16601
- UPMC Altoona
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Erie, Pennsylvania, Stany Zjednoczone, 16550
- UPMC Hamot
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Philadelphia, Pennsylvania, Stany Zjednoczone, 19104
- Hospital of the University of Pennsylvania
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Philadelphia, Pennsylvania, Stany Zjednoczone, 19107
- Thomas Jefferson University Hospital
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Philadelphia, Pennsylvania, Stany Zjednoczone, 19140
- Temple University Hospital, Philadelphia
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Pittsburgh, Pennsylvania, Stany Zjednoczone, 15213
- UPMC Presbyterian Hospital
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Rhode Island
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Providence, Rhode Island, Stany Zjednoczone, 02903
- Rhode Island Hospital
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South Carolina
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Charleston, South Carolina, Stany Zjednoczone, 29425
- Medical University of South Carolina University Hospital
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Columbia, South Carolina, Stany Zjednoczone, 29203
- Prisma Health Richland Hospital
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Greenville, South Carolina, Stany Zjednoczone, 29605
- Prisma Health Greenville Memorial Hospital
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Tennessee
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Memphis, Tennessee, Stany Zjednoczone, 38104
- Methodist University Hospital
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Texas
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Galveston, Texas, Stany Zjednoczone, 77555
- University of Texas Medical Branch
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Houston, Texas, Stany Zjednoczone, 77030
- Houston Methodist Hospital
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Houston, Texas, Stany Zjednoczone, 77030
- Memorial Hermann Texas Medical Center
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Lubbock, Texas, Stany Zjednoczone, 79410
- Covenant Medical Center
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Plano, Texas, Stany Zjednoczone, 75075
- Medical City Plano
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San Antonio, Texas, Stany Zjednoczone, 78229
- University of Texas Health Science Center San Antonio
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Tyler, Texas, Stany Zjednoczone, 75708
- UT Health Tyler
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Vermont
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Burlington, Vermont, Stany Zjednoczone, 05401
- The University of Vermont Medical Center
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Virginia
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Charlottesville, Virginia, Stany Zjednoczone, 22903
- UVA Medical Center
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Falls Church, Virginia, Stany Zjednoczone, 22042
- Inova Fairfax Hospital
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Roanoke, Virginia, Stany Zjednoczone, 24011
- Carilion Roanoke Memorial Hospital
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Washington
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Seattle, Washington, Stany Zjednoczone, 98104
- Harborview Medical Center
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Seattle, Washington, Stany Zjednoczone, 98122
- Swedish Medical Center - Cherry Hill Campus
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Wisconsin
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Madison, Wisconsin, Stany Zjednoczone, 53792
- University of Wisconsin University Hospital
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Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
Inclusion Criteria:
-
Acute focal symptoms or signs of any duration associated with imaging, pathological, or other objective evidence of arterial infarction OR clinical evidence of cerebral, spinal cord, or retinal focal arterial ischemic injury based on symptoms persisting greater than or equal to 24 hours that occurred within 30 days prior to randomization
-
Index stroke is attributed to 70-99% stenosis (or flow gap on MRA) of a major intracranial artery (carotid artery, middle cerebral artery (M1 or M2), vertebral artery (V4), basilar artery, posterior cerebral artery (P1), or anterior cerebral artery (A1)) documented by CTA, MRA, or catheter angiography
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Modified Rankin Scale score of ≤ 4, at time of consent
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Ability to swallow pills
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At least 30 years of age, inclusive, at time of consent
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Subjects 30-49 years of age are required to meet at least ONE of the following additional criteria below to qualify for the study:
- diabetes treated with insulin for at least 15 years
- at least 2 of the following atherosclerotic risk factors: hypertension (BP > 140/90 or on antihypertensive therapy); dyslipidemia (LDL > 130 mg /dl or HDL < 40 mg/dl or fasting triglycerides > 150 mg/dl or on lipid lowering therapy); smoking; non-insulin dependent diabetes or insulin dependent diabetes of less than 15 years duration; any of the following vascular events occurring in a parent or sibling who was < 55 years of age for men or < 65 years of age for women at the time of the event: myocardial infarction, coronary artery bypass, coronary angioplasty or stenting, stroke, carotid endarterectomy or stenting, peripheral vascular surgery for atherosclerotic disease
- personal history of any of the following: myocardial infarction, coronary artery bypass, coronary angioplasty or stenting, carotid endarterectomy or stenting, or peripheral vascular surgery for atherosclerotic disease
- any stenosis of an extracranial carotid or vertebral artery, another intracranial artery, subclavian artery, coronary artery, iliac or femoral artery, other lower or upper extremity artery, mesenteric artery, or renal artery that was documented by non-invasive vascular imaging or catheter angiography and is considered atherosclerotic
- aortic arch atheroma documented by non-invasive vascular imaging or catheter angiography
- any aortic aneurysm documented by non-invasive vascular imaging or catheter angiography that is considered atherosclerotic
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Negative pregnancy test in a female who has had any menses in the last 18 months and has not had surgery that would make her unable to become pregnant
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Subject is willing and able to return for all follow-up evaluations required by the protocol
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Subject is available by phone
-
Subject understands the purpose and requirements of the study and can make him/herself understood
-
Subject has provided informed consent (use of a LAR is not permitted)
Exclusion Criteria:
- Previous treatment of qualifying intracranial artery with a stent, angioplasty, or other mechanical device, including mechanical thrombectomy for the qualifying stroke, or plan to perform one of these procedures
- Plan to perform concomitant endarterectomy, angioplasty or stenting of an extracranial vessel tandem to the symptomatic intracranial stenosis
- Intracranial tumor (except meningioma) or any intracranial vascular malformation
- Thrombolytic therapy within 24 hours prior to randomization
- Progressive neurological signs within 24 hours prior to randomization
- History of spontaneous non-traumatic intracranial hemorrhage (parenchymal, subarachnoid, subdural, epidural)
- Intracranial arterial stenosis due to: arterial dissection; MoyaMoya disease; any known vasculitic disease; herpes zoster, varicella zoster or other viral vasculopathy; neurosyphilis; any other intracranial infection; any intracranial stenosis associated with CSF pleocytosis; radiation induced vasculopathy; fibromuscular dysplasia; sickle cell disease; neurofibromatosis; benign angiopathy of central nervous system; postpartum angiopathy; suspected vasospastic process; reversible cerebral vasoconstriction syndrome (RCVS); suspected recanalized embolus
- Presence of any of the following unequivocal cardiac sources of embolism: chronic or paroxysmal atrial fibrillation, mitral stenosis, mechanical valve, endocarditis, intracardiac clot or vegetation, myocardial infarction within three months, left atrial spontaneous echo contrast
- Known allergy or contraindication to aspirin, rivaroxaban, clopidogrel, or ticagrelor
- Uncontrolled severe hypertension (systolic pressure > 180 mm Hg or diastolic pressure > 115 mm Hg), active peptic ulcer disease, major systemic hemorrhage within 30 days prior to randomization, active bleed or bleeding diathesis, platelets < 100,000, hematocrit < 30, INR > 1.5, clotting factor abnormality that increases the risk of bleeding, current alcohol or substance abuse, severe liver impairment (AST or ALT > 3 x normal, cirrhosis), or CrCl < 15 mL/min or on dialysis
- Major surgery (including stenting of any vessel; open femoral, aortic, or carotid surgery; or cardiac surgery) within previous 30 days prior to randomization or planned in the next 90 days after randomization
- Any condition other than intracranial arterial stenosis that requires the subject to take any antithrombotic medication other than aspirin (NOTE: exceptions allowed for subcutaneous heparin or enoxaparin for deep vein thrombosis (DVT) prophylaxis)
- Dementia or psychiatric problem that prevents the subject from following an outpatient program reliably
- Co-morbid conditions that may limit survival to less than 12 months
- Pregnancy or of childbearing potential and unwilling to use contraception for the duration of this study, or currently breastfeeding
- Current or anticipated concomitant oral or intravenous therapy with strong CYP3A4 inhibitors or CYP3A4 substrates that cannot be stopped for the course of this study
- Enrollment in another study that would conflict with the current study
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Zapobieganie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Poczwórny
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
|
Eksperymentalny: Experimental Arm: Ticagrelor and Aspirin
Ticagrelor (180mg loading dose, then 90mg twice daily) and aspirin (81mg daily) |
ticagrelor (180 mg loading dose, then 90mg twice daily) and aspirin (81mg daily)
Inne nazwy:
Risk factors for stroke (LDL, blood pressure, non-HDL cholesterol, diabetes, smoking, weight, and physical activity) will be monitored and managed. |
|
Aktywny komparator: Standard of Care Arm: Clopidogrel and Aspirin
Clopidogrel (600mg loading dose, then 75mg once daily) and aspirin (81mg daily) |
Risk factors for stroke (LDL, blood pressure, non-HDL cholesterol, diabetes, smoking, weight, and physical activity) will be monitored and managed. clopidogrel (600mg loading dose, then 75mg daily) and aspirin (81mg daily)
Inne nazwy:
|
|
Eksperymentalny: Experimental Arm: Rivaroxaban and Aspirin
Rivaroxaban (2.5mg twice daily) and aspirin (81mg daily) |
Risk factors for stroke (LDL, blood pressure, non-HDL cholesterol, diabetes, smoking, weight, and physical activity) will be monitored and managed. low dose rivaroxaban (2.5mg twice daily) and aspirin (81mg daily)
Inne nazwy:
|
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Number of participants with parenchymal ICH or non-ICH major hemorrhage
Ramy czasowe: Up to 12 months
|
Non-ICH major hemorrhage is derived from the International Society on Thrombosis and Haemostasis (ISTH) criteria consisting of any of the following:
|
Up to 12 months
|
|
Number of participants with ischemic stroke, intracerebral hemorrhage or vascular death
Ramy czasowe: Up to 12 months
|
The definition of ischemic stroke is the American Heart Association definition that includes acute focal signs or symptoms of cerebral, spinal cord, or retinal involvement of any duration associated with imaging, pathological, or other objective evidence of arterial infarction OR clinical evidence of cerebral, spinal cord, or retinal focal arterial ischemic injury based on symptoms persisting greater than or equal to 24 hours. |
Up to 12 months
|
Współpracownicy i badacze
Sponsor
Współpracownicy
Śledczy
- Główny śledczy: Brian L. Hoh, MD, MBA, University of Florida
- Główny śledczy: Marc I. Chimowitz, MBChB, Medical University of South Carolina
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Dodatkowe istotne warunki MeSH
- Zaburzenia naczyniowo-mózgowe
- Choroby mózgu
- Choroby ośrodkowego układu nerwowego
- Choroby Układu Nerwowego
- Choroby naczyniowe
- Choroby układu krążenia
- Arterioskleroza
- Choroby okluzyjne tętnic
- Choroby tętnic wewnątrzczaszkowych
- Uderzenie
- Arterioskleroza wewnątrzczaszkowa
- Związki siarki
- Organiczne chemikalia
- Pirydyny
- Związki heterocykliczne, 1-ring
- Związki heterocykliczne
- Związki heterocykliczne, 2-ring
- Związki heterocykliczne, sterowanie stopieniem
- Kwasy nukleinowe, nukleotydy i nukleozydy
- Węglowodory
- Węglowodory, cykliczne
- Węglowodory, aromatyczne
- Puryny
- Fenole
- Pochodne benzenu
- Nukleozydy
- Rybonukleozydy
- Morfoliny
- Oksazyny
- Tiofeny
- Salicylaty
- Hydroksybenzoates
- Adenozyna
- Nukleozydy purynowe
- Tiklopidyna
- Thienopyrydyny
- Tikagrelor
- Klopidogrel
- Rywaroksaban
- Aspiryna
Inne numery identyfikacyjne badania
- CED000000522
- AWD10099 (Inny identyfikator: UFIRST)
- U01NS117450 (Grant/umowa NIH USA)
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
produkt wyprodukowany i wyeksportowany z USA
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