Comparing Intensive and Standard LDL-Cholesterol Targets for Preventing Recurring Small Vessel Occlusion Stroke

What this Trial Is About

Researchers are investigating the best low-density lipoprotein LDL cholesterol targets for patients who have had a small vessel occlusion SVO stroke, a type of ischemic stroke affecting small blood vessels in the brain. This study addresses the gap in knowledge about optimal LDL-cholesterol levels for SVO stroke patients, as most previous trials focused on other stroke types. The goal is to improve secondary prevention strategies and patient outcomes by comparing intensive versus standard lipid-lowering therapies. Participants will be randomly assigned to one of two groups an intensive treatment group aiming for LDL-cholesterol levels below 70 mgdL, and a standard treatment group targeting levels between 90 and 110 mgdL. Treatments include statins with or without ezetimibe, and if needed, PCSK9 inhibitors to reach the LDL targets. The trial is open-label with blinded endpoint evaluation and plans to enroll over 4,000 adults who had an SVO stroke within the past 180 days. Throughout the study, participants will be followed for at least four years to monitor major cardiovascular events, including cardiovascular death, stroke, and acute coronary syndrome. Researchers will assess outcomes such as any stroke, ischemic stroke or transient ischemic attack, myocardial infarction, and overall death. This long-term follow-up will help determine the most effective LDL-cholesterol management for secondary prevention in SVO stroke patients.

Optimal Target Low-density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke