New York Columbia Collaborative SPOTRIAS

纽约哥伦比亚急性卒中转化研究合作专业项目将涉及来自哥伦比亚大学和纽约长老会医院的关键人员。总体目标是加强急性卒中患者护理的提供，重点关注高危弱势人群，培训急性卒中转化研究人员，并开展3个创新的急性卒中项目。这些项目共享通过患者访问核心确定的主题，并利用血液和数据管理和统计核心。项目1是一项剂量递增和初步临床试验，旨在评价短期早期使用高剂量辛伐他汀治疗的效果（Neu-START：他汀类药物治疗急性恢复期神经保护试验）。 辛伐他汀在啮齿类动物中风模型中显示可减少神经元损伤和梗死面积，主要与改善血管流量和功能有关，而不是直接的神经元细胞保护益处。该转化项目将在12小时内随机分配60例IB期急性卒中和90例IIA期急性卒中，并评价安全性和全身炎症标志物的替代指标。项目2（急性卒中中的脑可塑性：功能性MRI研究）将通过评估急性期脑可塑性的作用来研究早期卒中结局中无法解释的变异性。为了确定急性卒中后对侧病变脑区的网络，预测1周和3个月时卒中恢复良好， 我们将招募100名急性中风患者，并在24至48小时内进行功能性磁共振成像扫描。项目3（SWIFT：中风警告信息和更快的治疗）的目的是减少弱势人群中急性中风患者到医院就诊的延迟。到 为了评估在三次互动会议上进行的文化敏感的、有针对性的教育/行为矫正计划的有效性，我们将随机选择1400名卒中ATIA幸存者和1200名社区受试者，并评估卒中知识和行为的变化，以及到达ED的时间的改善。

The New York Columbia Collaborative Specialized Program on Translational Research In Acute Stroke will involve key personnel from Columbia University and the NY Presbyterian Hospital. The overall goals are to enhance the delivery of acute stroke patient care with a focus on a high-risk disadvantaged population, train acute stroke translational researchers, and conduct 3 innovative acute stroke projects. The projects share subjects identified through the patient access core, and utilize blood and data management and statistics cores. Project 1 is a dose-escalation and pilot clinical trial to evaluate the effects of short-term early use of high-dose simvastatin therapy (Neu-START: Neuroprotection with Statin Therapy for Acute Recovery Trial). Simvastatin has been shown in rodent stroke models to reduce neuronal injury and infarct size primarily related to improving vascular flow and function rather than on a direct neuronal cytoprotective benefit. This translational project will randomize 60 acute strokes within 12 hours for phase IB and 90 within 6 hours for phase IIA and evaluate safety and surrogate measures of systemic inflammatory markers. Project 2 (Brain Plasticity in Acute Stroke: a Functional MRI Study) will investigate the unexplained variability in early stroke outcomes by evaluating the role of brain plasticity in the acute time period. To determine the network of contralesional brain regions after acute stroke that predicts good stroke recovery at 1 week and 3 months, we will recruit 100 acute stroke patients, and obtain fMRI scans at 24 to 48 hours. Project 3 (SWIFT: Stroke Warning Information and Faster Treatment) will be aimed at decreasing the delay in presentation of acute stroke patients to the hospital from a disadvantaged population. To evaluate the efficacy of a culturally sensitive, targeted educational/behavioral modification program performed over three interactive sessions, we will randomize 1400 strokeATIA survivors and 1200 community subjects and assess changes in stroke knowledge and behavior, as well as improvement in time to arrival to the ED.