ISRCTN ISRCTN44555237
DOI https://doi.org/10.1186/ISRCTN44555237
ClinicalTrials.gov number NCT00238667
Secondary identifying numbers Protocol version 8.1 (19th Janurary 2010)
Submission date
04/03/2007
Registration date
18/05/2007
Last edited
27/02/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Not provided at time of registration

Study website

Contact information

Prof Hugh Markus
Scientific

Centre for Clinical Neuroscience
St George's University of London
Cranmer Terrace
London
SW17 0RE
United Kingdom

Email hmarkus@sgul.ac.uk

Study information

Study designRandomised multicentre open treatment trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typeTreatment
Participant information sheet Patient information can be found at: http://www.sgul.ac.uk/dms/32EE671CBC5FEBFFE9794FC111A6BA0D.pdf
Scientific titleCervical Artery Dissection In Stroke Study
Study acronymCADISS
Study hypothesisIs therapy with anticoagulants better than treatment with antiplatelet agents for acute cervical artery dissection?

On 26/05/10 this record was updated to include changes in the protocol from v.3 (2007) to v.8.1 (2010). All updates can be found in the relevant field with the above update date. Please also note that the overall trial end date was changed from 01/01/10 to 31/12/11.
Ethics approval(s)South West London 3 Research Ethics Committee (formerly known as Wandsworth REC), 22/12/2004, ref: MREC 04/Q0803/215
ConditionStroke, carotid artery dissection and vertebral artery dissection
InterventionThis trial is currently recruiting in the United Kingdom as of 04/03/2007 - planning to extend internationally.

Patients will be randomised to either antiplatelet or anticoagulation therapy initially for at least 3 months, and thereafter at the discretion of the attending physician.

Arm 1: Antiplatelet therapy: Aspirin, dipyridamole or clopidogrel alone or in dual combination.
Arm 2: Anticoagulation with heparin (intravenous adminsitration, either unfractionated heparin or a therapeutic dose of low molecularweight heparin) followed by warfarin administered orally aiming for an coagulant response time (INR) in the range 2-3. Local protocols for heparin therapy can be used.

Treatment will be open-label. Low dose heparin prophylaxis for prevention of Deep Vein Thrombosis (DVT) is not a contra-indication, but its use should be recorded. Such prophylaxis may be continued after randomisation in the antiplatelet arm at the discretion of the local clinician. The doses of each drug used for antiplatelet therapy will be according to physician preference.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)anticoagulants, antiplatelet agents
Primary outcome measureTime to first ipsilateral stroke or death (any cause) within 3 months from randomisation
Secondary outcome measuresThe following will be measured at the 3-month follow up:

1. Ipsilateral TIA, stroke or death (any cause) within 3 months from randomisation
2. Any TIA and stroke
3. Any stroke
4. Major bleeding
5. Presence of residual stenosis at 3 months (>50%)
6. Mortality
Overall study start date01/04/2006
Overall study end date31/12/2011

Eligibility

Participant type(s)Patient
Age groupNot Specified
SexBoth
Target number of participants250 in feasibility phase
Participant inclusion criteria1. Extra cranial carotid or vertebral artery dissection with symptom onset within the last 7 days. This includes:
1.1. Ipsilateral Transient Ischemic Attack (TIA) or stroke with known date of onset
1.2. Ipsilateral Horner's syndrome or neck pain with known date of onset
2. Imaging evidence of definite or probable dissection on Magnetic Resonance Imaging (MRI)/ Magnetic Resonance Angiography (MRA), Computed Tomographic Angiography (CTA) or ultrasound (patients can be initially randomised on ultrasound alone but subsequent MR or CTA confirmation is needed)
Participant exclusion criteria1. Intracranial cerebral artery dissection
2. Symptom onset >7 days
3. Contraindications to either antiplatelet agents or anticoagulation therapy, including active peptic ulceration, bleeding peptic ulcer within 1 year
4. Patient refusal to consent
5. Patients already taking antiplatelets or anticoagulants for other reasons e.g. prosthetic heart valves in whom the treatment cannot be replaced by either antiplatelets or anticoagulants
6. Women who are pregnant

Added 26/05/10:
7. Iatrogenic induced dissection
Recruitment start date01/04/2006
Recruitment end date31/12/2011

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Centre for Clinical Neuroscience
London
SW17 0RE
United Kingdom

Sponsor information

St George's University of London (UK)
University/education

Research and Development Office
St George's University of London
Cranmer Terrace
London
SW17 0RE
England
United Kingdom

Email cadiss@sgul.ac.uk
ROR logo "ROR" https://ror.org/040f08y74

Funders

Funder type

Charity

Stroke association (UK)
Private sector organisation / Associations and societies (private and public)
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 01/11/2007 Yes No
Results article non-randomised arm results 14/08/2012 Yes No
Results article results 01/04/2015 Yes No
Results article results 01/06/2019 Yes No

Editorial Notes

27/02/2019: Publication reference added.