SAMMPRIS Trial [Neurosurgery Wiki]

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====== SAMMPRIS Trial ======
The aim of a study was to report the relationship between [[cognitive function]] and [[risk factor]]s at [[baseline]] and during follow-up in the [[Stenting]] and Aggressive Medical Management for Preventing Recurrent [[stroke]] in [[Intracranial]] [[Stenosis]] (SAMMPRIS) trial.

Subjects in the SAMMPRIS trial were included in this study. In order to have an assessment of [[cognitive]] function independent of stroke, patients with a stroke as a qualifying event whose deficits included [[aphasia]] or [[neglect]] were excluded from these analyses as were those with a [[cerebrovascular]] event during follow-up. The [[Montreal Cognitive Assessment]] (MoCA) score was used to assess cognitive impairment at baseline, 4 months, 12 months and closeout. Cognitive impairment was defined as MoCA < 26. A [[multivariate]] [[analysis]] was performed to determine what [[risk factor]]s were independent [[predictor]]s of [[cognitive function]] at baseline, 12 months and closeout. Among patients randomized to aggressive medical management only, the percentage of patients with cognitive impairment was compared between patients in versus out of target for each risk factor at 12 months and closeout.

Of the 451 patients in SAMMPRIS, 371 patients met the inclusion criteria. MoCA < 26 was present in 55% at baseline. [[Older]] [[age]] and physical inactivity were associated with cognitive impairment at baseline. Older age, non-white race, lower baseline [[body mass index]], and baseline cognitive impairment were associated with cognitive impairment at 12 months. In the aggressive medical management group, at 12 months, physical inactivity during follow-up was the strongest risk factor associated with cognitive impairment.

Cognitive impairment is common in patients with severe symptomatic [[intracranial atherosclerosis]]. Physical inactivity at baseline and during follow-up is a strong predictor of cognitive impairment
((Turan TN, Al Kasab S, Smock A, Cotsonis G, Bachman D, Lynn MJ, Nizam A,
Derdeyn CP, Fiorella D, Janis S, Lane B, Montgomery J, Chimowitz MI;
MBChB for the SAMMPRIS Investigators. Impact of Baseline Features and Risk Factor
Control on Cognitive Function in the Stenting and Aggressive Medical Management
for Preventing Recurrent Stroke in Intracranial Stenosis Trial. Cerebrovasc Dis. 
2019 Feb 14;47(1-2):24-31. doi: 10.1159/000497245. [Epub ahead of print] PubMed
PMID: 30763948.
)).