OPTIMIZING PRIMARY STROKE PREVENTION (STOP II)

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The proposed study is a follow-up to the Stroke Prevention Trial in Sickle Cell Anemia (STOP). STOP showed that children at high risk for stroke, among those with sickle cell anemia (SCA), can be identified through screening with transcranial doppler (TCD) ultrasound and that periodic transfusion reduces annual stroke incidence in high-risk patients from 10% to less than 1%. This is the first treatment strategy that prevented primary strokes in a randomized trial in this disease. It provides an opportunity to reduce the human and financial cost of stroke in SCA. However, a number of important questions that STOP was not designed to address remain unanswered, including how long treatment must be continued. The importance of this trial is that it will produce reliable information that can be used by clinicians and parents in making difficult decisions regarding the risks and benefits of continued transfusion for stroke prevention.