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Abstract Details

Baseline Differences in Risk Factor Control and Medication Use Between 2 Trials Employing Intensive Medical Management (SAMMPRIS & CREST2)
Cerebrovascular Disease and Interventional Neurology
P14 - Poster Session 14 (8:00 AM-9:00 AM)
4-017
NA
The CREST2 trial Intensive Medical Management (IMM) protocol was adapted from the SAMMPRIS trial. However, since the 2011 publication of initial results of SAMMPRIS, there has been a greater appreciation for the importance of risk factor control in patients at risk of stroke associated with atherosclerosis. Therefore, we sought to determine differences in baseline risk factor control and medication use between SAMMPRIS and CREST2. 
Baseline risk factor and medication use data from 451 patients enrolled in SAMMPRIS (2008-2011) with severe symptomatic intracranial atherosclerosis and 1473 patients enrolled in CREST2 (2014-2019) with severe asymptomatic carotid stenosis were compared using the Chi-square test and t-test. 
SAMMPRIS patients were younger but had significantly worse risk factor control than CREST2 patients for all measures, including LDL, SBP, BMI, physical activity, and smoking. There was no significant difference in statin use at baseline, but the mean SAMMPRIS subjects’ LDL was 16.1 mg/dL higher than in CREST2. CREST2 patients had higher rates of use of angiotensin receptor blockers (ARB), calcium channel blockers (CCB), and thiazides, but lower rates of use of angiotensin converting enzyme (ACE) inhibitors. 
Despite being older, CREST2 patients have significantly better baseline risk factor profiles than SAMMPRIS patients. This could be due to greater appreciation of the importance of risk factor control and healthy lifestyle habits for stroke prevention or more aggressive treatment targets in guideline recommendations.  Although risk factor control appears to be improving since SAMMPRIS, many CREST2 patients are still not meeting recommended risk factor goals at baseline and may benefit from IMM protocols.  
Authors/Disclosures
Tanya N. Turan, MD, FÂ鶹´«Ã½Ó³»­ (Medical University of South Carolina)
PRESENTER 		Dr. Turan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer/Merck. Dr. Turan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Gore Inc. Dr. Turan has received publishing royalties from a publication relating to health care. Dr. Turan has received publishing royalties from a publication relating to health care.
Jenifer Voeks Jenifer Voeks has nothing to disclose.
Kevin M. Barrett, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Barrett has nothing to disclose.
Robert D. Brown, Jr., MD, MPH, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Brown has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Craig H Neilsen Foundation. The institution of Dr. Brown has received research support from National Institutes of Health/NINDS. Dr. Brown has received publishing royalties from a publication relating to health care.
Seemant Chaturvedi, MD, FAHA, FÂ鶹´«Ã½Ó³»­ (University of Maryland) Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Chaturvedi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Chaturvedi has received research support from NINDS.
Marc I. Chimowitz, MD (MUSC Stroke Center) An immediate family member of Dr. Chimowitz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gore. Dr. Chimowitz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NoNo Inc. The institution of Dr. Chimowitz has received research support from NIH.
Bart Demaerschalk, MD, MSc, FRCPC, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Demaerschalk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Demaerschalk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Demaerschalk has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for The Neurologist . The institution of Dr. Demaerschalk has received research support from NICHD.
Prabhu D. Emmady, MD, MBA (Atrium Health) No disclosure on file
George Howard, PhD (UAB School of Public Hlth) Dr. Howard has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer.
Virginia J. Howard, PhD (University of Alabama At Birmingham) The institution of Dr. Howard has received research support from NIH. The institution of an immediate family member of Dr. Howard has received research support from NIH.
No disclosure on file
No disclosure on file
Brajesh K. Lal (University of Maryland) Brajesh K. Lal has nothing to disclose.
No disclosure on file
Claudia Moy, PhD Claudia Moy, PhD has nothing to disclose.
No disclosure on file
No disclosure on file
Navdeep Sangha, MD (Kaiser Permanente) Dr. Sangha has nothing to disclose.
Thomas G. Brott, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Brott has nothing to disclose.
James F. Meschia, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) The institution of Dr. Meschia has received research support from NINDS. The institution of Dr. Meschia has received research support from NINDS.