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

Recruiting now · Not applicable

Conditions studied: Ischemic Stroke, Small Vessel Cerebrovascular Disease, Cholesterol, LDL, Secondary Prevention, Cardiovascular Diseases

In brief

Lipid-lowering therapy constitutes a cornerstone of secondary prevention in ischemic stroke; however, current stroke guidelines remain deficient in providing optimal target low-density lipoprotein (LDL)-cholesterol levels tailored to the stroke subtypes. Most clinical trials on LDL-cholesterol management have not differentiated between stroke subtypes or have primarily focused on large artery atherosclerosis (LAA) stroke, leaving a gap in evidence for managing LDL-cholesterol in other stroke subtypes, e.g., small vessel occlusion (SVO) stroke. While hypertension is the leading risk factor for SVO strokes, the link between elevated LDL-cholesterol and SVO stroke is also recognized. Establishing optimal LDL-cholesterol targets for SVO stroke would significantly enhance secondary prevention strategies and improve patient outcome. Thus, the investigators aim to compare intensive versus standard lipid-lowering in patients with SVO stroke. SVO70 is a multicenter, prospective, randomized, open, blinded-endpoint clinical trial. Adult participants with objectively confirmed SVO stroke within 180 days of randomization will be included. Exclusion criteria include those with predefined LDL-cholesterol targets for other conditions, statin contraindications, or women who are pregnant, breastfeeding, or planning pregnancy during the study period. Eligible participants will be randomized 1:1 to target LDL-cholesterol \<70 mg/dL (intensive group) or 90-110 mg/dL (standard group). The trial plans to enroll 4,016 participants, with the primary outcome being major adverse cardiovascular events-cardiovascular death, stroke, and acute coronary syndrome-during a follow-up period of at least 4 years. This study would provide valuable information for determining the optimal LDL-cholesterol target for patients with SVO stroke.

Key facts

Study ID

NCT06649240

Run by

Seoul National University Hospital

People needed

4016

Starts

2024-10-04

Expected to finish

2030-09-01

Last updated by the study team

2025-05-21

Who can join

Age: 19 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age 19 years or older
• Patients with objectively confirmed small vessel occlusive infarctions in the subcortical or brainstem regions, identified through neuroimaging (MRI or CT)
• Patients with a history of symptomatic ischemic stroke caused by the lesion described in 2), occurring within 180 days prior to enrollment
• Patients or guardians who agree to the study protocol and sign with informed consent

You may not qualify if…

• Patients requiring intensive LDL cholesterol management (LDL-C <70 mg/dL) due to another condition, with LDL cholesterol targets specified in the guidelines for that condition
• Patients contraindicated for statin use (e.g., active liver disease, serum transaminase levels elevated more than three times the normal limit, muscle disorders, hypersensitivity to statins, or taking medications contraindicated for use with statins)
• Women who are pregnant, breastfeeding, or intending to become pregnant during the study period
• Deemed unsuitable for participation in the study for more than four years, as per the investigators' discretion

Where it is running

• Yongin Severance Hospital — Yongin, South Korea (enrolling)
• Hallym University Sacred Heart Hospital — Anyang, South Korea (enrolling)
• Pusan National University Hospital — Busan, South Korea (enrolling)
• Gyeongsang National University Changwon Hospital — Changwon, South Korea (enrolling)
• Samsung Changwon Hospital — Changwon, South Korea (enrolling)
• Chungbuk National University Hospital — Cheongju-si, South Korea (enrolling)
• Hallym University Chuncheon Sacred Heart Hospital — Chuncheon, South Korea (enrolling)
• Kangwon National University Hospital — Chuncheon, South Korea (enrolling)
• Daegu Catholic University Medical Center — Daegu, South Korea (enrolling)
• Keimyung University Dongsan Medical Center — Daegu, South Korea (enrolling)
• Kyungpook National University Chilgok Hospital — Daegu, South Korea (enrolling)
• Kyungpook National University Hospital — Daegu, South Korea (enrolling)
• Chungnam National University Hospital — Daejeon, South Korea (enrolling)
• Daejeon Eulji Medical Center — Daejeon, South Korea (enrolling)
• Dongguk University Ilsan Hospital — Goyang, South Korea (enrolling)
• Ilsan Paik Hospital — Goyang, South Korea (enrolling)
• National Health Insurance Service Ilsan Hospital — Goyang, South Korea (enrolling)
• Hanyang University Guri Hospital — Guri-si, South Korea (enrolling)
• Chonnam National University Hospital — Gwangju, South Korea (enrolling)
• Chosun University Hospital — Gwangju, South Korea (enrolling)
• Chung-Ang University Gwangmyeong Hospital — Gwangmyeong, South Korea (enrolling)
• Dongtan Sacred Heart Hospital — Hwaseong, South Korea (enrolling)
• Wonkwang University Hospital — Iksan, South Korea (enrolling)
• Gachon University Gil Medical Center — Incheon, South Korea (enrolling)
• Inha University Hospital — Incheon, South Korea (enrolling)

Full record on ClinicalTrials.gov

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