Abstract 217: Impact of the New Aha/asa Definition of Stroke on the Outcome of The SAMMPRIS Trial for The SAMMPRIS Investigators
Background: The AHA/ASA have recently recommended that cerebral infarction associated with temporary symptoms or signs (CITS) lasting < 24 hours should be considered a stroke. We analyzed the impact of including CITS in the territory of the symptomatic artery as a primary endpoint on the results of the SAMMPRIS trial.
Methods: We compared the outcome of patients in the medical vs. stenting (PTAS) groups in SAMMPRIS using the following primary endpoint: any stroke, CITS or death within 30 days after enrollment or after a revascularization procedure for the qualifying lesion during follow up or stroke or CITS in the territory of the qualifying artery beyond 30 days. We also compared the use of brain MRI after TIAs in both treatment groups.
Results: The Kaplan-Meier curves for these events in the two groups were significantly different (p = 0.009) with the following rates in the medical group versus PTAS group: 6.7% versus 15.6% at day 30 (p=0.002), 16.3% versus 25.1% at year 1 (p=0.022), and 19.4% versus 30.3% at year 3 (p=0.009). The percentage of patients with reported TIAs who underwent brain MRI was 69% (34/49) in the medical group and 61% (28/46) in the PTAS group (p=0.40).
Conclusion: CITS in the territory occurred more frequently during follow-up in the PTAS group than in the medical group, which cannot be attributed to imaging ascertainment bias. These results imply an even higher benefit from medical therapy over stenting and a higher risk of symptomatic cerebral infarction in both groups than originally described in SAMMPRIS.
Author Disclosures: S. Al Kasab: None. M.J. Lynn: None. T.N. Turan: Research Grant; Significant; NINDS grant for intracranial plaque imaging. C.P. Derdeyn: Ownership Interest; Modest; Pulse Therapeutics. Consultant/Advisory Board; Modest; Microvention, Penumbra, Silk Road, Pulse Therapeutics. D. Fiorella: None. B.F. Lane: None. J. Montgomery: None. S. Janis: None. M.I. Chimowitz: Employment; Significant; NINDS. Research Grant; Significant; U01NS058728.
- © 2015 by American Heart Association, Inc.