ChiCTR2400084027 版本V1.1 版本创建时间2025/06/13 16:45:23 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2400084027 

最近更新日期:

Date of Last Refreshed on:

2024-05-09 11:09:18 

注册时间:

Date of Registration:

2024-05-09 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

PCSK9抑制剂是否减少缺血性卒中早期复发的多中心前瞻性随机对照研究

Public title:

PCSK9 Inhibitors Prevent the Early Recurrent Stroke: A Multicenter Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

PCSK9抑制剂是否减少缺血性卒中早期复发的多中心前瞻性随机对照研究

Scientific title:

PCSK9 Inhibitors Prevent the Early Recurrent Stroke: A Multicenter Randomized Controlled Trial

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

姜永军 

研究负责人:

姜永军 

Applicant:

Jiang Yongjun 

Study leader:

Jiang Yongjun 

申请注册联系人电话:

Applicant telephone:

+86 13951756253

研究负责人电话:

Study leader's telephone:

+86 20 34152747

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

jiangyjnju@gmail.com

研究负责人电子邮件:

Study leader's E-mail:

jiangyjnju@gmail.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

广东省广州市海珠区昌岗东路250号

研究负责人通讯地址:

广州市海珠区昌岗东路250号

Applicant address:

250 Changgang East Road, Guangzhou, China

Study leader's address:

250 Changgang East Road, Haizhu District, Guangzhou

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

广州医科大学附属第二医院

Applicant's institution:

The Second Affiliated Hospital of Guangzhou Medical University

研究负责人所在单位:

广州医科大学附属第二医院

Affiliation of the Leader:

Second Affiliated Hospital of Guangzhou Medical University

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2023-hs-71

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

广州医科大学附属第二医院临床研究与应用伦理委员会

Name of the ethic committee:

The Second Affiliated Hospital of Guangzhou Medical University Clinical Research and Application Institutional Review Board Approval Document

伦理委员会批准日期:

Date of approved by ethic committee:

2023-10-20 00:00:00

伦理委员会联系人:

陈娟

Contact Name of the ethic committee:

Chen Juan

伦理委员会联系地址:

广州市海珠区昌岗东路250号

Contact Address of the ethic committee:

250 Changgang East Road, Haizhu District, Guangzhou

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 20 34153599

伦理委员会联系人邮箱:

Contact email of the ethic committee:

1612179125@qq.com

研究实施负责(组长)单位:

广州医科大学附属第二医院

Primary sponsor:

Second Affiliated Hospital of Guangzhou Medical University

研究实施负责(组长)单位地址:

广州市海珠区昌岗东路250号

Primary sponsor's address:

250 Changgang East Road, Haizhu District, Guangzhou

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

广东

市(区县):

Country:

China

Province:

Guangdong

City:

单位(医院):

广州医科大学附属第二医院

具体地址:

广州市海珠区昌岗东路250号

Institution
hospital:

Second Affiliated Hospital of Guangzhou Medical University

Address:

250 Changgang East Road, Haizhu District, Guangzhou

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self selected topic (self raised)

Target disease:

acute ischemic stroke

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究的目的是在多个中心进行前瞻性随机对照研究,用于评估PCSK9抑制剂添加治疗(PCSK9抑制剂+中等强度他汀类药物,可联用/不联用依折麦布)相比于传统降脂治疗(中等强度他汀类药物,可联用/不联用依折麦布),是否可减少缺血性卒中早期复发比例。  

Objectives of Study:

The objective of this study is to conduct a prospective, multi-center, randomized controlled study to evaluate whether PCSK9 inhibitor add-on therapy (PCSK9 inhibitor plus moderate-intensity statins with or without ezetimibe) can reduce the risk of early recurrence of ischemic stroke compared to conventional lipid-lowering therapy (moderate-strength statins with or without ezetimibe).

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1.年龄≥18岁;
2.满足以下条件其一:起病3天内的短暂性脑缺血发作(ABCD2基线评分≥4);起病3天内的缺血性卒中(mRS评分≤4分),由CT/MRI证实病灶;
3.卒中事件由颅内动脉狭窄引起(颈内动脉 C5-C7段、大脑前动脉、大脑中动脉、椎动脉V3-V4段、大脑后动脉和基底动脉,狭窄程度 50-99%),并经由MRA/CTA/DSA诊断;
4.TOAST分型为大动脉粥样硬化型;
5.患者或法定代理人理解研究的目的和要求,并签署知情同意书;

Inclusion criteria

1.Age 18 or over;
2.Meeting one of the following conditions: A recent transient ischemic attack (baseline ABCD2 ≥ 4) within the past 3 days, or a recent acute ischemic stroke (mRS ≤4) confirmed by CT/MRI within the past 3 days;
3.Stroke attributed to intracranial artery stenosis (including internal carotid artery [C5-C7], anterior or middle cerebral artery, vertebral artery [V3-V4], posterior cerebral artery or basilar artery, stenotic degree: 50%-99%) confirmed by MRA, CTA or DSA;
4.TOAST classification as large artery atherosclerosis;
5.Patients or their legally authorized representatives understand the purpose and requirements of the present study, and sign the informed consent.;

排除标准:

1.存在同侧串联颅外动脉狭窄(≥50%)或不能确定责任血管;
2.任何已知的非动脉粥样硬化型颅内动脉狭窄,包括但不限于动脉夹层,烟雾病,血管炎,病毒性血管病,神经梅毒,颅内感染,放射性血管病,纤维肌发育不良,镰状细胞病,神经纤维瘤病,可逆性血管收缩综合征,产后血管病,血管痉挛,疑似血管栓塞后再通;
3.入组前30天内接受过颅内外动脉血管内治疗或30天内计划行血管内治疗(包括血管成形术、血管内膜剥脱和机械取栓术);
4.有颅内出血,包括脑实质出血,蛛网膜下腔出血,硬膜下出血或硬膜外出血,除外SWI发现的颅内微出血;
5.入组前存在巨大颅内肿瘤、巨大脑动脉瘤或动静脉畸形;
6.存在以下任何明确的心源性栓塞来源:二尖瓣狭窄、机械瓣膜、心内膜炎、心内凝血块或赘生物、三个月内的心肌梗死、扩张型心肌病、房颤、左心房自发性超声显影、射血分数<30%、未经治疗的III级卵圆孔未闭;
7.严重的心肝肾功能不全:纽约心脏病协会(NYHA)心功能III 级或 IV 级;肾小球滤过率GFR<30 ml/min/1.73m2,或需要血液透析或腹膜透析;AST和/或ALT >正常上限的3倍;肌酐清除率<0.6 mL/s 和/或血清肌酐>265μmol/L (3.0 mg/dL);肌酸激酶>正常上限的5倍;
8.活动性消化道溃疡,活动性出血倾向:纠正后国际标准化比值> 1.5,出血时间超过上限值 1 分钟,或因肝素相关血小板减少症增加出血风险;入组前30天内发生重大全身性出血;
9.入组前或入组后30天内进行手术,包括心脏和开放性股骨、主动脉或颈动脉手术;
10.既往有可影响到神经功能评分或预后评分的神经系统或精神疾病;严重的神经功能缺陷,使患者无法独立生活;已诊断为痴呆或精神疾病,妨碍患者完成随访计划;
11.预期寿命不满30天;
12.计划或处于妊娠期、哺乳期;
13.在入组之前 24 周使用过PCSK9抑制剂;
14.患有系统性免疫病:系统性硬化症,系统性红斑狼疮,干燥综合征,白塞病,混合性结缔组织病,IgG4 相关性疾病;
15.在筛选期内不能控制的高血压,定义为坐位收缩压>185mmHg 或舒张压>110 mmHg;
16.有核磁成像的相对/绝对禁忌征(如体内金属,幽闭恐惧症,造影剂过敏、严重肾损害、正在发作的癫痫、低血压、甲亢、哮喘及其他变态反应性呼吸道疾病患者及有过敏倾向者);
17.正在参与与当前研究冲突的研究。;

Exclusion criteria:

1.Ipsilateral tandem extracranial artery stenosis (≥50%) or undefined responsible vessel;
2.Any known non-atherosclerotic intracranial arterial stenosis, including but not limited to intracranial arterial dissection, moyamoya disease, vasculitis, viral vasculopathy, neurosyphilis, intracranial infection, radiation vasculopathy, fibromuscular dysplasia, sickle cell disease, neurofibromatosis, reversible vasoconstriction syndrome, postpartum vascular disease, vasospasm, suspected recanalization post vascular embolism;
3.Received intracranial or extracranial arterial endovascular treatment within 30 days before enrollment or plan to receive intracranial or extracranial arterial endovascular treatment (including angioplasty, endarterectomy or mechanical thrombectomy) within 30 days;
4.Intracranial hemorrhage, including cerebral parenchymal hemorrhage, subarachnoid hemorrhage, subdural hemorrhage or epidural hemorrhage, except for the intracranial microbleed detected by SWI;
5.Huge intracranial tumors, intracranial aneurysms or arteriovenous malformations before enrollment;
6.Presence of any of the following definite cardiogenic sources of embolism: mitral stenosis, mechanical valve, endocarditis, intracardiac clot or vegetation, myocardial infarction within 3 months, dilated cardiomyopathy, atrial fibrillation, left atrium spontaneous ultrasound development, ejection fraction <30%, or untreated grade III patent foramen ovale;
7.Severe cardiac, liver or renal insufficiency: New York Heart Association (NYHA) cardiac functional class III or IV, glomerular filtration rate (GFR) <30 ml/min/1.73m2, or requiring hemodialysis or peritoneal dialysis, AST and/or ALT >3 times the upper reference limit, creatinine clearance <0.6 mL/s and/or serum creatinine >265 μmol/L (3.0 mg/dL), creatine kinase >5 times the upper reference limit;
8.Active peptic ulcer, active bleeding tendency: corrected international normalized ratio > 1.5, bleeding time exceeding the upper reference limit for 1 minute, or increased bleeding risk due to heparin-related thrombocytopenia, major systemic bleeding within 30 days before enrollment;
9.Surgery within 30 days before or after enrollment, including cardiac surgery, open femoral surgery, aortic or carotid artery surgery;
10.Suffering from neurological or mental diseases which could affect neurological function scores or prognostic scores, having severe neurological deficits that prevent the patient from living independently, diagnosed with dementia or mental illness, which prevents the patient from completing the follow-up plan;
11.Life expectancy less than 30 days;
12.Women who plan to become pregnant, are pregnant or breastfeeding;
13.Received PCSK9 inhibitors within the past 24 weeks before enrollment;
14.Suffering from systemic immune diseases: systemic sclerosis, systemic lupus erythematosus, Sjogren's syndrome, Behcet's disease, mixed connective tissue disease, IgG4-related diseases;
15.Uncontrolled hypertension (systolic blood pressure > 185mmHg, or diastolic blood pressure > 110mmHg) during the screening period;
16.With relative/absolute contraindications of MRI (such as metals in the body, claustrophobia, contrast agent allergy, severe renal damage, ongoing epilepsy, hypotension, hyperthyroidism, asthma and other allergic respiratory diseases, or with allergic tendencies);
17.Participating in trials which conflict with the present study.;

研究实施时间:

Study execute time:

From 2023-11-01 00:00:00 To 2025-11-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2024-01-22 00:00:00 To 2025-10-31 00:00:00  

干预措施:

Interventions:

组别:

干预组

样本量:

750

Group:

Intervention group

Sample size:

干预措施:

PCSK9抑制剂添加治疗

干预措施代码:

Intervention:

PCSK9 inhibitors add-on therapy

Intervention code:

组别:

对照组

样本量:

750

Group:

Control group

Sample size:

干预措施:

传统降脂治疗

干预措施代码:

Intervention:

Traditional lipid lowering therapy

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

广州医科大学附属第二医院 

单位级别:

三级甲等 

Institution
hospital:

Second Affiliated Hospital of Guangzhou Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

广州医科大学附属第二医院 

单位级别:

三级甲等 

Institution
hospital:

Second Affiliated Hospital of Guangzhou Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

中山大学附属第一医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital,Sun Yat-sen University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

广州市第一人民医院 

单位级别:

三级甲等 

Institution
hospital:

Guabgzhou First People‘s Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

广州市番禺区何贤纪念医院(广州市番禺区妇幼保健院) 

单位级别:

三级甲等 

Institution
hospital:

PanYu Hexian Memorial Hospital of Guangzhou(PanYu Maternal and Child Care Service Centre of Guangzhou)

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

广州医科大学附属市八医院 

单位级别:

三级甲等 

Institution
hospital:

Guangzhou Eighth Peoples Hospital Guangzhou Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

广州市第十二人民医院 

单位级别:

三级医院 

Institution
hospital:

Guangzhou Twelfth People’s Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China 

Province:

Shanghai 

City:

 

单位(医院):

上海中医药大学附属曙光医院 

单位级别:

三级甲等 

Institution
hospital:

Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China 

Province:

Jiangsu 

City:

 

单位(医院):

苏州大学附属第一医院 

单位级别:

三级甲等 

Institution
hospital:

the First Affiliated Hospital of Soochow University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

深圳市龙华区中心医院 

单位级别:

三级医院 

Institution
hospital:

Shenzhen Longhua District Central Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

深圳市中西医结合医院 

单位级别:

三级甲等 

Institution
hospital:

Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

南方医科大学中西医结合医院 

单位级别:

三级甲等 

Institution
hospital:

Integrated Chinese and Western Medicine Hospital of Southern Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China 

Province:

Jiangsu 

City:

 

单位(医院):

无锡市人民医院 

单位级别:

三级甲等 

Institution
hospital:

Wuxi people’s Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China 

Province:

Guangdong 

City:

 

单位(医院):

广州市花都区人民医院 

单位级别:

三级甲等 

Institution
hospital:

Huadu District Peoples Hospital of Guangzhou

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

30天mRS 0-5

指标类型:

次要指标

Outcome:

30-day mRS 0-5

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天

测量方法:

改良的Rankin评分

Measure time point of outcome:

30(±7) days after randomization

Measure method:

Modified Rankin Scale

指标中文名:

30天内复合血管终点事件

指标类型:

次要指标

Outcome:

30-day composite vascular endpoints

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天内

测量方法:

计数30天内再发缺血性卒中、30天内再发TIA(仅记录第一次再发卒中时间)、30天内颅内出血、30天内急性冠脉综合征(包括急性心肌梗死、需要住院的不稳定型心绞痛、行经皮冠脉成形术或行冠脉搭桥手术)、30天内急性外周动脉疾病(包括急性外周动脉闭塞、行外周动脉血运重建)。

Measure time point of outcome:

within 30(±7) days after randomization

Measure method:

Counting the recurrence of ischemic stroke within 30 days, recurrence of TIA within 30 days (only the first recurrence of stroke is recorded), intracranial hemorrhage within 30 days, acute coronary syndrome (including acute myocardial infarction, unstable angina pectoris requiring hospitalization, receiving percutaneous coronary angioplasty or coronary artery bypass surgery) within 30 days, acute peripheral arterial diseases within 30 days (including acute peripheral arterial occlusion, receivin

指标中文名:

30天内卒中相关死亡

指标类型:

次要指标

Outcome:

30-day stroke-related death

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天内

测量方法:

计数卒中相关死亡病例

Measure time point of outcome:

within 30(±7) days after randomization

Measure method:

counting death cases related to stroke

指标中文名:

30天内血管性死亡

指标类型:

次要指标

Outcome:

30-day vascular related death

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天内

测量方法:

计数血管事件相关死亡病例

Measure time point of outcome:

within 30(±7) days after randomization

Measure method:

counting death cases related to vascular events

指标中文名:

30天不良事件发生率

指标类型:

次要指标

Outcome:

The incidence of adverse events within 30 days

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天

测量方法:

计数两组间30天内不良事件的发生率

Measure time point of outcome:

30(±7) days after randomization

Measure method:

Counting the incidence of adverse events within 30 days between the two groups

指标中文名:

实验室指标

指标类型:

次要指标

Outcome:

Laboratory tests

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天

测量方法:

测量随机化后30±7天TC、LDL-C、TG、HDL-C、Lp(a)、ApoB、CK、hsCRP/CRP、肝肾功能。

Measure time point of outcome:

30(±7) days after randomization

Measure method:

Testing the TC, LDL-C, TG, HDL-C, Lp(a), ApoB, CK, hsCRP/CRP, liver and kidney function on 30±7 days after randomization.

指标中文名:

30天内再发缺血性卒中/TIA

指标类型:

主要指标

Outcome:

recurrence ischemic stroke/TIA within 30 days

Type:

Primary indicator

测量时间点:

随机化后30(±7)天内

测量方法:

计数30天内缺血性脑卒中/TIA

Measure time point of outcome:

within 30(±7) days after randomization

Measure method:

counting the recurrent ischemic stroke/TIA within 30 days

指标中文名:

30天内全因死亡

指标类型:

主要指标

Outcome:

All-cause mortality within 30 days

Type:

Primary indicator

测量时间点:

随机化后30(±7)天内

测量方法:

计算30天内全因死亡率

Measure time point of outcome:

within 30(±7) days after randomization

Measure method:

counting the all-cause mortality within 30 days after randomization

指标中文名:

30天mRS评分0-1

指标类型:

次要指标

Outcome:

30-day mRS 0-1

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天

测量方法:

改良的Rankin评分

Measure time point of outcome:

30(±7) days after randomization

Measure method:

Modified Rankin Scale

指标中文名:

30天mRS 0-2

指标类型:

次要指标

Outcome:

30-day mRS 0-2

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天

测量方法:

改良的Rankin评分

Measure time point of outcome:

30(±7) days after randomization

Measure method:

Modified Rankin Scale

指标中文名:

30天mRS 0-3

指标类型:

次要指标

Outcome:

30-day mRS 0-3

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天

测量方法:

改良的Rankin评分

Measure time point of outcome:

30(±7) days after randomization

Measure method:

Modified Rankin Scale

指标中文名:

30天mRS 0-4

指标类型:

次要指标

Outcome:

30-day mRS 0-4

Type:

Secondary indicator

测量时间点:

随机化后30(±7)天

测量方法:

改良的Rankin评分

Measure time point of outcome:

30(±7) days after randomization

Measure method:

Modified Rankin Scale

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 99 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

姜永军采用网络随机

Randomization Procedure (please state who generates the random number sequence and by what method):

web-based biased-coin randomization

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

开放标签,对评估者隐藏分组

Blinding:

Open-label study with blinded-evaluators

是否共享原始数据:

IPD sharing

Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

本研究的原始数据将在文章发表后6个月之内公开共享。共享 原始数据的的方式为:上传到临床试验公共管理平台ResMan (www.medresman.org.cn)。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

The individual participant data of this study will be made known to the public within 6 months after publication. The way to share individual participant data is to Upload to the ResMan (www.medresman.org.cn).

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

CRF和EDC

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CRF and EDC

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2024-05-09 11:08:58