Clinical features and racial/ethnic differences among the 3020 participants in the secondary prevention of small subcortical strokes (SPS3) trial

Carole L. White, Jeff M. Szychowski, Ana Roldan, Marie France Benavente, Edwin J. Pretell, Oscar H. Del Brutto, Carlos S. Kase, Antonio Arauz, Brett C. Meyer, Irene Meissner, Bart M Demaerschalk, Leslie A. McClure, Christopher S. Coffey, Lesly A. Pearce, Robin Conwit, Lisa H. Irby, Kalyani Peri, Pablo E. Pergola, Robert G. Hart, Oscar R. Benavente

Research output: Contribution to journalArticle

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Abstract

This study examined the baseline characteristics, racial/ethnic differences, and geographic differences among participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) study. The SPS3 trial enrolled patients who experienced a symptomatic small subcortical stroke (lacunar stroke) within the previous 6 months and an eligible lesion on detected on magnetic resonance imaging. The patients were randomized, in a factorial design, to antiplatelet therapy (aspirin 325 mg daily plus clopidogrel 75 mg daily vs aspirin 325 mg daily plus placebo) and to one of two levels of systolic blood pressure targets ("intensive" [<130 mmHg] or "usual" [130-149 mmHg]). A total of 3020 participants were recruited from 81 clinical sites in 8 countries. In this cohort, the mean age was 63 years, 63% were men, 75% had a history of hypertension, and 37% had diabetes. The racial distribution was 51% white, 30% Hispanic, and 16% black. Compared with white subjects, black subjects were younger (mean age, 58 years vs 64 years; P <.001) and had a higher prevalence of hypertension (87% vs 70%; P <.001). The prevalence of diabetes was higher in the Hispanic and black subjects compared with the white subjects (42% and 40% vs 32%; both P <.001). Tobacco smoking at the time of qualifying stroke was much more frequent in the Spanish participants than in subjects from North America and from Latin America (32%, 22%, and 9%, respectively; P <.001). Mean systolic blood pressure at study entry was 4 mmHg lower in the Spanish subjects compared with the North American subjects (P <.01). The SPS3 cohort is the largest magnetic resonance imaging-defined series of patients with S3. Among the racially/ethnically diverse SPS3 participants, important differences in patient features and vascular risk factors could influence prognosis for recurrent stroke and response to interventions.

Original languageEnglish (US)
Pages (from-to)764-774
Number of pages11
JournalJournal of Stroke and Cerebrovascular Diseases
Volume22
Issue number6
DOIs
StatePublished - Aug 2013

Fingerprint

Secondary Prevention
Stroke
Blood Pressure
clopidogrel
Hispanic Americans
Aspirin
Magnetic Resonance Imaging
Hypertension
Lacunar Stroke
Latin America
North America
Smoking
Placebos
Therapeutics

Keywords

  • antiplatelet
  • blood pressure
  • clinical trial
  • cognition
  • Lacunar
  • prevention
  • small vessel disease

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

Cite this

Clinical features and racial/ethnic differences among the 3020 participants in the secondary prevention of small subcortical strokes (SPS3) trial. / White, Carole L.; Szychowski, Jeff M.; Roldan, Ana; Benavente, Marie France; Pretell, Edwin J.; Del Brutto, Oscar H.; Kase, Carlos S.; Arauz, Antonio; Meyer, Brett C.; Meissner, Irene; Demaerschalk, Bart M; McClure, Leslie A.; Coffey, Christopher S.; Pearce, Lesly A.; Conwit, Robin; Irby, Lisa H.; Peri, Kalyani; Pergola, Pablo E.; Hart, Robert G.; Benavente, Oscar R.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 22, No. 6, 08.2013, p. 764-774.

Research output: Contribution to journalArticle

White, CL, Szychowski, JM, Roldan, A, Benavente, MF, Pretell, EJ, Del Brutto, OH, Kase, CS, Arauz, A, Meyer, BC, Meissner, I, Demaerschalk, BM, McClure, LA, Coffey, CS, Pearce, LA, Conwit, R, Irby, LH, Peri, K, Pergola, PE, Hart, RG & Benavente, OR 2013, 'Clinical features and racial/ethnic differences among the 3020 participants in the secondary prevention of small subcortical strokes (SPS3) trial', Journal of Stroke and Cerebrovascular Diseases, vol. 22, no. 6, pp. 764-774. https://doi.org/10.1016/j.jstrokecerebrovasdis.2012.03.002
White, Carole L. ; Szychowski, Jeff M. ; Roldan, Ana ; Benavente, Marie France ; Pretell, Edwin J. ; Del Brutto, Oscar H. ; Kase, Carlos S. ; Arauz, Antonio ; Meyer, Brett C. ; Meissner, Irene ; Demaerschalk, Bart M ; McClure, Leslie A. ; Coffey, Christopher S. ; Pearce, Lesly A. ; Conwit, Robin ; Irby, Lisa H. ; Peri, Kalyani ; Pergola, Pablo E. ; Hart, Robert G. ; Benavente, Oscar R. / Clinical features and racial/ethnic differences among the 3020 participants in the secondary prevention of small subcortical strokes (SPS3) trial. In: Journal of Stroke and Cerebrovascular Diseases. 2013 ; Vol. 22, No. 6. pp. 764-774.
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AU - Pretell, Edwin J.

AU - Del Brutto, Oscar H.

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