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The REstart or STop Antithrombotics Randomised Trial (RESTART) after stroke due to intracerebral haemorrhage: study protocol for a randomised controlled trial

机译:脑出血引起的卒中后REstart或Stop抗血栓形成药物随机试验(RESTART):一项随机对照试验的研究方案

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For adults surviving stroke due to spontaneous (non-traumatic) intracerebral haemorrhage (ICH) who had taken an antithrombotic (i.e. anticoagulant or antiplatelet) drug for the prevention of vaso-occlusive disease before the ICH, it is unclear whether starting antiplatelet drugs results in an increase in the risk of recurrent ICH or a beneficial net reduction of all serious vascular events compared to avoiding antiplatelet drugs. The REstart or STop Antithrombotics Randomised Trial (RESTART) is an investigator-led, randomised, open, assessor-blind, parallel-group, randomised trial comparing starting versus avoiding antiplatelet drugs for adults surviving antithrombotic-associated ICH at 122 hospital sites in the United Kingdom. RESTART uses a central, web-based randomisation system using a minimisation algorithm, with 1:1 treatment allocation to which central research staff are masked. Central follow-up includes annual postal or telephone questionnaires to participants and their general (family) practitioners, with local provision of information about adverse events and outcome events. The primary outcome is recurrent symptomatic ICH. The secondary outcomes are: symptomatic haemorrhagic events; symptomatic vaso-occlusive events; symptomatic stroke of uncertain type; other fatal events; modified Rankin Scale score; adherence to antiplatelet drug(s). The magnetic resonance imaging (MRI) sub-study involves the conduct of brain MRI according to a standardised imaging protocol before randomisation to investigate heterogeneity of treatment effect according to the presence of brain microbleeds. Recruitment began on 22 May 2013. The target sample size is at least 720 participants in the main trial (at least 550 in the MRI sub-study). Final results of RESTART will be analysed and disseminated in 2019. ISRCTN71907627 ( www.isrctn.com/ISRCTN71907627 ). Prospectively registered on 25 April 2013.
机译:对于因自发性(非创伤性)脑出血(ICH)而中风幸存的成年人,他们在ICH之前服用了抗血栓(即抗凝或抗血小板)药物预防血管闭塞性疾病,目前尚不清楚开始使用抗血小板药物是否会导致与避免使用抗血小板药物相比,复发性ICH的风险增加或所有严重血管事件的有效净减少。 REstart或Stop抗血栓形成药物随机试验(RESTART)是一项由研究人员主导的,随机,开放,评估者盲,平行组,随机试验,比较了在美国122个医院地点接受抗血栓相关性ICH的成年人开始使用和避免使用抗血小板药物的情况。王国。 RESTART使用基于中央,基于网络的随机化系统,该系统使用最小化算法,对1:1的治疗分配进行了分配,而中央研究人员则被掩盖。集中的后续活动包括向参与者及其全科医生(家庭)提供年度邮政或电话调查表,并在本地提供有关不良事件和结果事件的信息。主要结果是复发性ICH。次要结果是:症状性出血事件;有症状的血管闭塞事件;不确定类型的症状性中风;其他致命事件;改良的兰金量表评分;对抗血小板药物的依从性。磁共振成像(MRI)子研究包括根据标准化成像协议进行脑MRI,然后根据脑微出血的存在情况随机化,以研究治疗效果的异质性。招募工作于2013年5月22日开始。目标样本量至少为720名主要试验参与者(MRI子研究中至少为550名参与者)。 RESTART的最终结果将在2019年进行分析和发布。ISRCTN71907627(www.isrctn.com/ISRCTN71907627)。预计于2013年4月25日注册。

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