07 Jan Aggressive Medical Management For Patients At Highest Risk of Recurrent Stroke
MedicalResearch.com Interview with:
Michael F. Waters, MD, PhD
Department of Neurology
Department of Neuroscience
McKnight Brain Institute
University of Florida College of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Waters: This study was based on a subgroup of medically managed patients with severe, symptomatic, intracranial, atherosclerotic disease. Historically we know that these patients have a very high rate of additional strokes, and multiple studies have attempted to determine the best management for these patients. In SAMMPRIS, we were able to prove that aggressive medical management was superior to stenting in these patients. However, certain patients in the medically managed group still had a very high rate of repeat strokes, as much as 30% of those with certain risk factors. This study was an attempt to identify those risk factors to determine which patients were at the greatest risk for another stroke.
Medical Research: What should clinicians and patients take away from your report?
Dr. Waters: They should understand the risk factors associated with the greatest likelihood of a repeat stroke in their patient population. These patients should be followed very closely and have frequent monitoring of their risk factors in an effort to prevent another stroke. We have medical therapies that are effective for prevention. This should be stressed to your patients.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Waters: We will need to develop improved therapies for this subgroup of patients at the highest risk. Even though we know that medical therapy is better for the aggregate group, this subgroup suffers from an unacceptably high rate of additional strokes. Future research will be aimed at improving preventative strategies for these patients.
Waters MF, Hoh BL, Lynn MJ, et al. Factors Associated With Recurrent Ischemic Stroke in the Medical Group of the SAMMPRIS Trial.JAMA Neurol. Published online January 04, 2016. doi:10.1001/jamaneurol.2015.4315
Michael F. Waters, MD, PhD (2016). Aggressive Medical Management For Patients At Highest Risk of Recurrent Stroke