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PreventIon of CArdiovascular Events in iSchemic Stroke Patients With High Risk of Cerebral HemOrrhage (PICASSO)

Primary Purpose

Brain Ischemia, Intracranial Hemorrhages

Status
Unknown status
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Cilostazol
Probucol
Aspirin
placebo of cilostazol
placebo of aspirin
ankle-brachial index (ABI)
intima-medial thickness (IMT)
new asymptomatic brain hemorrhage
new ischemic lesions on follow-up FLAIR images
Sponsored by
Asan Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Brain Ischemia focused on measuring Ischemic Stroke, Intracranial Hemorrhage, Cilostazol, Probucol

Eligibility Criteria

20 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients with transient ischemic attack (TIA) or ischemic stroke within 180 days prior to screening - Adult aged 20 years or older
  • High risk of hemorrhagic stroke (history of intracranial hemorrhage or imaging evidence of previous intracranial hemorrhage)
  • Informed consent

Exclusion Criteria:

  • Clinical diagnosis of myocardial infarction or coronary intervention within 4 weeks
  • Bleeding tendency
  • Pregnant or breast-feeding woman
  • Hemorrhagic stroke within 6 months
  • Patient who was taking antithrombotic medication other than aspirin and does not agree to change the previous medication
  • Severe cardiovascular disease such as cardiomyopathy or congestive heart failure
  • Life expectancy less than one year
  • Contraindication to long term aspirin use
  • Enrolled in other clinical trial within 30 days

Sites / Locations

  • Pamela Youde Nethersole Eastern Hospital
  • Queen Elizabeth Hospital
  • United Christian Hospital
  • Prince of Wales Hospital
  • Chungbuk National University Hospital
  • Soonchunhyang University Cheonan Hospital
  • Wonju Christian Hospital
  • Kwandong University College of Medicine Myongji Hospital
  • Gyeongsang National University Hospital
  • Korea University Ansan Hospital
  • Soonchunhyang University Bucheon Hospital
  • National Health Insurance Corporation Ilsan Hoapital
  • Inje University Ilsan Paik Hospital
  • Hanyang University Guri Hospital
  • Bundang Medical Center, CHA University
  • Uijeongbu St. Mary's Hospital
  • Samsung changwon Medical Center
  • Wonkwang University Hospital
  • Chonbuk National University Hospital
  • Kangwon National University Hospital
  • Chang Won Fatima hospital
  • Dongguk University International Hospital
  • Hallym University Sacred Heart Hospital
  • Seoul National University Bundang Hospital
  • Ajou University Hospital
  • Kosin University Gospel Hospital
  • Inje University Pusan Paik Hospital
  • Pusan National University Hospital
  • Dong-A University Hospital
  • Keimyung University Dongsan Center
  • Daegu Fatima Hospital
  • Eulji University Hospital
  • Dongsan Medical Center
  • Kyungpook National University Hospital
  • Yeungnam University Medical Center
  • Deagu Catholic University Hospital
  • Chungnam National University Hospital
  • Deajeon St.Mary's Hospital, The Catholic University of Korea
  • Chosun University Hospital
  • Chonnam National University Hospital
  • Gachon University Gil Hoapital
  • Inha University Hospital
  • Wallace Memorial Baptist Hospital
  • National Medical Center
  • Kangbuk Samsung Hospital
  • Severance Hospital
  • Kyung Hee University Medical Center
  • Hanyang University Medical Center
  • Kangdong Sacred Heart Hospital, Hallym University
  • Gangnam Severance Hospital
  • Seoul Medical Center
  • Korea University Anam Hospital
  • Seoul St.Mary's Hospital
  • Asan Medical Center
  • Inje University Sanggye Paik Hospital
  • Konkuk Univ. Hospital
  • St. Mary's Hospital
  • Hangang Sacred Heart Hospital
  • Kangnam Sacred Heart Hospital, Hallym University College of Medicine
  • Korea University Guro Hospital
  • Seoul National University Borame Hospital
  • Ewha Womans University Medical Center
  • Eulji Hospital
  • Chung-Ang University Medical Center
  • Seoul National University Hospital
  • Soonchunhyang University Hospital
  • Ulsan University Hospital
  • Manila Doctors Hospital
  • University of Santo Tomas
  • The Medical City
  • St. Luke's Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Active Comparator

Experimental

Active Comparator

Arm Label

Cilostazol+ Probucol

Aspirin + Probucol

Cilostazol

Aspirin

Arm Description

100mg cilostazol bid plus probucol plus placebo of aspirin

aspirin plus placebo cilostazol plus probucol

cilostazol plus placebo of aspirin

aspirin plus placebo of cilostazol

Outcomes

Primary Outcome Measures

Time to the first occurrence of cerebral hemorrhage
Time to the first occurence of composite cardiovascular events

Secondary Outcome Measures

Time to the first occurrence of stroke
Time to the first occurrence of ischemic stroke
Time to the first occurence of myocardial infarction
Time to the first occurence of other designated vascular events

Full Information

First Posted
November 10, 2009
Last Updated
December 23, 2015
Sponsor
Asan Medical Center
Collaborators
Korea Otsuka Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01013532
Brief Title
PreventIon of CArdiovascular Events in iSchemic Stroke Patients With High Risk of Cerebral HemOrrhage
Acronym
PICASSO
Official Title
A Multicenter, Double Blind, Factorial Design, Phase IV Trial to Compare the Efficacy and Safety of Cilostazol Long-term Treatment With Aspirin in Ischemic Stroke Patients With High Risk of Cerebral Hemorrhage for the Prevention of Cerebral Hemorrhage and Cardiovascular Events and to Compare the Preventive Effect of Probucol in the Same Patient Group With Non-drug User Group for the Prevention of Cardiovascular Events
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Unknown status
Study Start Date
June 2009 (undefined)
Primary Completion Date
September 2016 (Anticipated)
Study Completion Date
December 2016 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Asan Medical Center
Collaborators
Korea Otsuka Pharmaceutical Co., Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Through this study, the investigators are to prove that Cilostazol effectively prevent cardiovascular events in ischemic stroke patients with high risk of cerebral hemorrhage, along with no significant increase in the risk of occurrence of hemorrhagic side effects. The primary hypothesis of this study is; Cilostazol alone or with probucol will reduce the risk of cerebral hemorrhage without increase of cardiovascular events compared to aspirin in the ischemic stroke patients with symptomatic or asymptomatic old cerebral hemorrhage. This study will prove the superiority of cilostazol on the prevention of cerebral hemorrhagic events without increasing the cardiovascular events against aspirin and the superiority of probucol on the prevention of overall cardiovascular events.
Detailed Description
It has been generally accepted that 'old age' and 'hypertension' may be risk factors not only for cerebral infarction but also for cerebral hemorrhage. Usually 40 to 60 percent of recurrent strokes after cerebral hemorrhage cases are cerebral infarction; and 5 to 10 percent of recurrent stroke after cerebral infarction cases are cerebral hemorrhage. Consequently, for the reasons described above, hemorrhagic side effects including cerebral hemorrhage have been a great concern, in the usage of antiplatelet agent or anticoagulant for the secondary prevention in the patients with cerebral infarction. It is reported that the occurrence of cerebral hemorrhage tends to increase in cases of accompanying lacunar infarction which occurs more frequently in Asians than in Westerners, or periventricular ischemic change which increasingly occurs with ageing. Accordingly, the point is that the occurrence of cerebral hemorrhage should be primarily considered in the treatment of cerebral infarction, along with the phenomenon of an ageing population both in Asian countries including Korea. Nevertheless, so far there has been no clinical research regarding secondary prevention of stroke, particularly considering the risk of occurrence of hemorrhage in cerebral infarction cases. However, according to a recent study, when phosphodiesterase inhibitors including Cilostazol are used independently, or in combination with aspirin, secondary prevention can be improved without increasing the occurrence of hemorrhagic side effects. Considering this, if it is proved that the agent, Cilostazol, could decrease the risk of occurrence of stoke, along with no significant increase in the risk of occurrence of hemorrhagic side effects, by selecting a patent group with a high risk of cerebral hemorrhage, the agent (Cilostazol) may be recognized as an unique antiplatelet agent applicable to old-aged patient with cerebral infarction who have a certain risk of cerebral hemorrhage. High risk of cerebral hemorrhage is defined as presence of history of cerebral hemorrhage with appropriate neuroimage findings or presence of asymptomatic old cerebral hemorrhage findings(equal or more than 8mm) or multiple microbleeds on the GRE images. 1600 ischemic stroke patients with high risk of cerebral hemorrhage will be recruited and they are randomized into four groups (cilostazol plus probucol, aspirin plus probucol, cilostazol and aspirin) by 2X2 factorial design. IMT and ABI will be measured every year during follow-up period and the results will be compared with the baseline data. The change of IMT and ABI will be analyzed with the occurrence of cardiovascular events. The study will finish at least 1 year after the recruit of 1600th patients. Until the finish, all patients will continuously take study medications and visit every 3months at the study site. Brain MRI including FLAIR and GRE will be done at the final visits.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain Ischemia, Intracranial Hemorrhages
Keywords
Ischemic Stroke, Intracranial Hemorrhage, Cilostazol, Probucol

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Factorial Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1600 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cilostazol+ Probucol
Arm Type
Experimental
Arm Description
100mg cilostazol bid plus probucol plus placebo of aspirin
Arm Title
Aspirin + Probucol
Arm Type
Active Comparator
Arm Description
aspirin plus placebo cilostazol plus probucol
Arm Title
Cilostazol
Arm Type
Experimental
Arm Description
cilostazol plus placebo of aspirin
Arm Title
Aspirin
Arm Type
Active Comparator
Arm Description
aspirin plus placebo of cilostazol
Intervention Type
Drug
Intervention Name(s)
Cilostazol
Other Intervention Name(s)
Pletaal produced by Korea Otsuka Pharmaceutical company
Intervention Description
Cilostazol 100mg bid
Intervention Type
Drug
Intervention Name(s)
Probucol
Other Intervention Name(s)
Probucol is produced by Otsuka Pharmaceutical
Intervention Description
Probucol 250mg bid
Intervention Type
Drug
Intervention Name(s)
Aspirin
Intervention Description
Aspirin 100mg qd
Intervention Type
Drug
Intervention Name(s)
placebo of cilostazol
Intervention Description
same shape and size of active cilostazol
Intervention Type
Drug
Intervention Name(s)
placebo of aspirin
Intervention Description
same size and shape of active aspirin 100mg
Intervention Type
Device
Intervention Name(s)
ankle-brachial index (ABI)
Intervention Description
measurement of ABI every years during follow up
Intervention Type
Device
Intervention Name(s)
intima-medial thickness (IMT)
Other Intervention Name(s)
change of maximal IMT and mean IMT
Intervention Description
ultrasound measured IMT of both common carotid arteries
Intervention Type
Device
Intervention Name(s)
new asymptomatic brain hemorrhage
Intervention Description
asymptomatic macrobleedings or microbleedings on GRE images
Intervention Type
Device
Intervention Name(s)
new ischemic lesions on follow-up FLAIR images
Intervention Description
any new ischemic lesions
Primary Outcome Measure Information:
Title
Time to the first occurrence of cerebral hemorrhage
Time Frame
time since randomization; follow-up period is 1.0 to 5.5 years
Title
Time to the first occurence of composite cardiovascular events
Time Frame
time since randomization; follow-up period is 1.0 to 5.5 years
Secondary Outcome Measure Information:
Title
Time to the first occurrence of stroke
Time Frame
time since randomization; follow-up period is 1.0 to 5.5 years
Title
Time to the first occurrence of ischemic stroke
Time Frame
time since randomization; follow-up period is 1.0 to 5.5 years
Title
Time to the first occurence of myocardial infarction
Time Frame
time since randomization; follow-up period is 1.0 to 5.5 years
Title
Time to the first occurence of other designated vascular events
Time Frame
time since randomization; follow-up period is 1.0 to 5.5 years
Other Pre-specified Outcome Measures:
Title
Incidence rate of major and non-major hemorrhagic event
Time Frame
time since randomization; follow-up period is 1.0 to 5.5 years
Title
Rate of asymptomatic hemorrhage in GRE (microhemorrhage or macrohemorrhage)
Time Frame
at final visit, follow-up MRI will be checked at the final visit
Title
Rate of new asymptomatic cerebral infarction lesion in FLAIR
Time Frame
at final visit, follow-up MRI will be checked at the final visit
Title
Change of ankle-brachial index
Time Frame
at final visit;follow-up period is 1.0 to 5.5 years
Title
The effect of the size of common carotid artery(CCA) including plaque on the occurrence of cardiovascular events
Time Frame
at final visit;follow-up period is 1.0 to 5.5 years
Title
Time to all deaths including vascular and non-vascular deaths
Time Frame
time since randomization; follow-up period is 1.0 to 5.5 years
Title
Incidence rate of dementia diagnosed after initiation of the trial
Time Frame
time since randomization; follow-up period is 1.0 to 5.5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with transient ischemic attack (TIA) or ischemic stroke within 180 days prior to screening - Adult aged 20 years or older High risk of hemorrhagic stroke (history of intracranial hemorrhage or imaging evidence of previous intracranial hemorrhage) Informed consent Exclusion Criteria: Clinical diagnosis of myocardial infarction or coronary intervention within 4 weeks Bleeding tendency Pregnant or breast-feeding woman Hemorrhagic stroke within 6 months Patient who was taking antithrombotic medication other than aspirin and does not agree to change the previous medication Severe cardiovascular disease such as cardiomyopathy or congestive heart failure Life expectancy less than one year Contraindication to long term aspirin use Enrolled in other clinical trial within 30 days
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sun U. Kwon, MD, PhD
Organizational Affiliation
Departement of Neurology, Asan Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Pamela Youde Nethersole Eastern Hospital
City
Hong Kong
State/Province
Hong Kong
Country
China
Facility Name
Queen Elizabeth Hospital
City
Hong Kong
State/Province
Hong Kong
Country
China
Facility Name
United Christian Hospital
City
Hong Kong
State/Province
Hong Kong
Country
China
Facility Name
Prince of Wales Hospital
City
Shatin, NT
State/Province
Hong Kong
Country
China
Facility Name
Chungbuk National University Hospital
City
Cheongju
State/Province
Chungbuk
ZIP/Postal Code
361-711
Country
Korea, Republic of
Facility Name
Soonchunhyang University Cheonan Hospital
City
Cheonan
State/Province
Chungcheongnam-do
ZIP/Postal Code
330-721
Country
Korea, Republic of
Facility Name
Wonju Christian Hospital
City
Wonju
State/Province
Gangwon-do
ZIP/Postal Code
220-701
Country
Korea, Republic of
Facility Name
Kwandong University College of Medicine Myongji Hospital
City
Gyeonggi-do
State/Province
Goyang
ZIP/Postal Code
412-270
Country
Korea, Republic of
Facility Name
Gyeongsang National University Hospital
City
Jinju
State/Province
Gyengsangnam-do
ZIP/Postal Code
660-702
Country
Korea, Republic of
Facility Name
Korea University Ansan Hospital
City
Ansan
State/Province
Gyeonggi-do
ZIP/Postal Code
152-703
Country
Korea, Republic of
Facility Name
Soonchunhyang University Bucheon Hospital
City
Bucheon
State/Province
Gyeonggi-do
ZIP/Postal Code
420-020
Country
Korea, Republic of
Facility Name
National Health Insurance Corporation Ilsan Hoapital
City
Goyang-si
State/Province
Gyeonggi-do
ZIP/Postal Code
411-719
Country
Korea, Republic of
Facility Name
Inje University Ilsan Paik Hospital
City
Goyang
State/Province
Gyeonggi-do
ZIP/Postal Code
411-706
Country
Korea, Republic of
Facility Name
Hanyang University Guri Hospital
City
Guri
State/Province
Gyeonggi-do
ZIP/Postal Code
471-701
Country
Korea, Republic of
Facility Name
Bundang Medical Center, CHA University
City
Seongnam-si
State/Province
Gyeonggi-do
ZIP/Postal Code
463-712
Country
Korea, Republic of
Facility Name
Uijeongbu St. Mary's Hospital
City
Uijeongbu
State/Province
Gyeonggi-do
ZIP/Postal Code
480-821
Country
Korea, Republic of
Facility Name
Samsung changwon Medical Center
City
Changwon
State/Province
Gyeongsangnam-do
ZIP/Postal Code
630-723
Country
Korea, Republic of
Facility Name
Wonkwang University Hospital
City
Iksan
State/Province
Jeonbuk
ZIP/Postal Code
570-711
Country
Korea, Republic of
Facility Name
Chonbuk National University Hospital
City
Jeonju-si
State/Province
Jeonbuk
ZIP/Postal Code
561-712
Country
Korea, Republic of
Facility Name
Kangwon National University Hospital
City
Chuncheon
State/Province
Kangwon-do
ZIP/Postal Code
200-947
Country
Korea, Republic of
Facility Name
Chang Won Fatima hospital
City
Changwon
State/Province
Kyeongsangnam-do
ZIP/Postal Code
641-560
Country
Korea, Republic of
Facility Name
Dongguk University International Hospital
City
Goyang
State/Province
Kyoungki-do
ZIP/Postal Code
410-773
Country
Korea, Republic of
Facility Name
Hallym University Sacred Heart Hospital
City
Anyang
State/Province
Kyunggi
ZIP/Postal Code
430-070
Country
Korea, Republic of
Facility Name
Seoul National University Bundang Hospital
City
Seongnam
State/Province
Kyunggi
Country
Korea, Republic of
Facility Name
Ajou University Hospital
City
Suwon
State/Province
Kyunggi
Country
Korea, Republic of
Facility Name
Kosin University Gospel Hospital
City
Busan
ZIP/Postal Code
602-702
Country
Korea, Republic of
Facility Name
Inje University Pusan Paik Hospital
City
Busan
ZIP/Postal Code
614-735
Country
Korea, Republic of
Facility Name
Pusan National University Hospital
City
Busan
ZIP/Postal Code
626-770
Country
Korea, Republic of
Facility Name
Dong-A University Hospital
City
Busan
Country
Korea, Republic of
Facility Name
Keimyung University Dongsan Center
City
Daegu
ZIP/Postal Code
700-712
Country
Korea, Republic of
Facility Name
Daegu Fatima Hospital
City
Daegu
ZIP/Postal Code
701-600
Country
Korea, Republic of
Facility Name
Eulji University Hospital
City
Daejon
ZIP/Postal Code
302-799
Country
Korea, Republic of
Facility Name
Dongsan Medical Center
City
Deagu
ZIP/Postal Code
700-712
Country
Korea, Republic of
Facility Name
Kyungpook National University Hospital
City
Deagu
ZIP/Postal Code
700-721
Country
Korea, Republic of
Facility Name
Yeungnam University Medical Center
City
Deagu
ZIP/Postal Code
705-717
Country
Korea, Republic of
Facility Name
Deagu Catholic University Hospital
City
Deagu
ZIP/Postal Code
705-718
Country
Korea, Republic of
Facility Name
Chungnam National University Hospital
City
Deajeon
ZIP/Postal Code
301-721
Country
Korea, Republic of
Facility Name
Deajeon St.Mary's Hospital, The Catholic University of Korea
City
Deajeon
ZIP/Postal Code
303-723
Country
Korea, Republic of
Facility Name
Chosun University Hospital
City
GwangJu
ZIP/Postal Code
501-717
Country
Korea, Republic of
Facility Name
Chonnam National University Hospital
City
Gwangju
ZIP/Postal Code
501-757
Country
Korea, Republic of
Facility Name
Gachon University Gil Hoapital
City
Incheon
ZIP/Postal Code
405-760
Country
Korea, Republic of
Facility Name
Inha University Hospital
City
Inchon
ZIP/Postal Code
400-103
Country
Korea, Republic of
Facility Name
Wallace Memorial Baptist Hospital
City
Pusan
ZIP/Postal Code
609-728
Country
Korea, Republic of
Facility Name
National Medical Center
City
Seoul
ZIP/Postal Code
100-799
Country
Korea, Republic of
Facility Name
Kangbuk Samsung Hospital
City
Seoul
ZIP/Postal Code
110-746
Country
Korea, Republic of
Facility Name
Severance Hospital
City
Seoul
ZIP/Postal Code
120-752
Country
Korea, Republic of
Facility Name
Kyung Hee University Medical Center
City
Seoul
ZIP/Postal Code
130-702
Country
Korea, Republic of
Facility Name
Hanyang University Medical Center
City
Seoul
ZIP/Postal Code
133-792
Country
Korea, Republic of
Facility Name
Kangdong Sacred Heart Hospital, Hallym University
City
Seoul
ZIP/Postal Code
134-701
Country
Korea, Republic of
Facility Name
Gangnam Severance Hospital
City
Seoul
ZIP/Postal Code
135-720
Country
Korea, Republic of
Facility Name
Seoul Medical Center
City
Seoul
ZIP/Postal Code
135-740
Country
Korea, Republic of
Facility Name
Korea University Anam Hospital
City
Seoul
ZIP/Postal Code
136-705
Country
Korea, Republic of
Facility Name
Seoul St.Mary's Hospital
City
Seoul
ZIP/Postal Code
137-701
Country
Korea, Republic of
Facility Name
Asan Medical Center
City
Seoul
ZIP/Postal Code
138-736
Country
Korea, Republic of
Facility Name
Inje University Sanggye Paik Hospital
City
Seoul
ZIP/Postal Code
139-707
Country
Korea, Republic of
Facility Name
Konkuk Univ. Hospital
City
Seoul
ZIP/Postal Code
143-729
Country
Korea, Republic of
Facility Name
St. Mary's Hospital
City
Seoul
ZIP/Postal Code
150-713
Country
Korea, Republic of
Facility Name
Hangang Sacred Heart Hospital
City
Seoul
ZIP/Postal Code
150-719
Country
Korea, Republic of
Facility Name
Kangnam Sacred Heart Hospital, Hallym University College of Medicine
City
Seoul
ZIP/Postal Code
150-950
Country
Korea, Republic of
Facility Name
Korea University Guro Hospital
City
Seoul
ZIP/Postal Code
152-703
Country
Korea, Republic of
Facility Name
Seoul National University Borame Hospital
City
Seoul
ZIP/Postal Code
156-707
Country
Korea, Republic of
Facility Name
Ewha Womans University Medical Center
City
Seoul
ZIP/Postal Code
158-710
Country
Korea, Republic of
Facility Name
Eulji Hospital
City
Seoul
ZIP/Postal Code
280-1
Country
Korea, Republic of
Facility Name
Chung-Ang University Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul National University Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Soonchunhyang University Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Ulsan University Hospital
City
Ulsan
Country
Korea, Republic of
Facility Name
Manila Doctors Hospital
City
Manila
Country
Philippines
Facility Name
University of Santo Tomas
City
Manila
Country
Philippines
Facility Name
The Medical City
City
Pasig
Country
Philippines
Facility Name
St. Luke's Medical Center
City
Quezon City
Country
Philippines

12. IPD Sharing Statement

Citations:
PubMed Identifier
34779245
Citation
Park JH, Lee J, Kwon SU, Sung Kwon H, Hwan Lee M, Kang DW. Elevated Pulse Pressure and Recurrent Hemorrhagic Stroke Risk in Stroke With Cerebral Microbleeds or Intracerebral Hemorrhage. J Am Heart Assoc. 2022 Feb;11(3):e022317. doi: 10.1161/JAHA.121.022317. Epub 2021 Nov 15.
Results Reference
derived
PubMed Identifier
34155277
Citation
Cho KH, Kwon SU, Lee JS, Yu S, Cho AH. Newly diagnosed diabetes has high risk for cardiovascular outcome in ischemic stroke patients. Sci Rep. 2021 Jun 21;11(1):12929. doi: 10.1038/s41598-021-92349-y.
Results Reference
derived
PubMed Identifier
32664827
Citation
Park HK, Lee JS, Kim BJ, Park JH, Kim YJ, Yu S, Hwang YH, Rha JH, Heo SH, Ahn SH, Seo WK, Park JM, Lee JH, Kwon JH, Sohn SI, Jung JM, Kwon SU, Hong KS; PICASSO investigators. Cilostazol versus aspirin in ischemic stroke with cerebral microbleeds versus prior intracerebral hemorrhage. Int J Stroke. 2021 Dec;16(9):1019-1030. doi: 10.1177/1747493020941273. Epub 2020 Jul 14.
Results Reference
derived
PubMed Identifier
32027796
Citation
Lee EJ, Kwon SU, Park JH, Kim YJ, Hong KS, Yu S, Hwang YH, Lee JS, Lee J, Rha JH, Heo SH, Ahn SH, Seo WK, Park JM, Lee JH, Kwon JH, Sohn SI, Jung JM, Kim HY, Kim EG, Kim SH, Cha JK, Park MS, Nam HS, Kang DW; PICASSO Investigators. Changes in High-Density Lipoprotein Cholesterol and Risks of Cardiovascular Events: A Post Hoc Analysis from the PICASSO Trial. J Stroke. 2020 Jan;22(1):108-118. doi: 10.5853/jos.2019.02551. Epub 2020 Jan 31.
Results Reference
derived
PubMed Identifier
31856691
Citation
Kim BJ, Kwon SU, Park JH, Kim YJ, Hong KS, Wong LKS, Yu S, Hwang YH, Lee JS, Lee J, Rha JH, Heo SH, Ahn SH, Seo WK, Park JM, Lee JH, Kwon JH, Sohn SI, Jung JM, Navarro JC, Kim HY, Kim EG, Kim S, Cha JK, Park MS, Nam HS, Kang DW; PICASSO Investigators. Cilostazol Versus Aspirin in Ischemic Stroke Patients With High-Risk Cerebral Hemorrhage: Subgroup Analysis of the PICASSO Trial. Stroke. 2020 Mar;51(3):931-937. doi: 10.1161/STROKEAHA.119.023855. Epub 2019 Dec 20.
Results Reference
derived
PubMed Identifier
29778364
Citation
Kim BJ, Lee EJ, Kwon SU, Park JH, Kim YJ, Hong KS, Wong LKS, Yu S, Hwang YH, Lee JS, Lee J, Rha JH, Heo SH, Ahn SH, Seo WK, Park JM, Lee JH, Kwon JH, Sohn SI, Jung JM, Navarro JC, Kang DW; PICASSO investigators. Prevention of cardiovascular events in Asian patients with ischaemic stroke at high risk of cerebral haemorrhage (PICASSO): a multicentre, randomised controlled trial. Lancet Neurol. 2018 Jun;17(6):509-518. doi: 10.1016/S1474-4422(18)30128-5.
Results Reference
derived
PubMed Identifier
24957314
Citation
Park TH, Lee JS, Park SS, Ko Y, Lee SJ, Lee KB, Lee J, Kang K, Park JM, Choi JC, Kim DE, Cho YJ, Kim JT, Kim DH, Cha JK, Han MK, Lee J, Oh MS, Yu KH, Lee BC, Bae HJ, Hong KS. Safety and efficacy of intravenous recombinant tissue plasminogen activator administered in the 3- to 4.5-hour window in Korea. J Stroke Cerebrovasc Dis. 2014 Aug;23(7):1805-12. doi: 10.1016/j.jstrokecerebrovasdis.2014.04.027. Epub 2014 Jun 21.
Results Reference
derived

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PreventIon of CArdiovascular Events in iSchemic Stroke Patients With High Risk of Cerebral HemOrrhage

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