Scandinavian Candesartan Acute Stroke Trial (SCAST)


Phase 3 Results N/A

Eligibility Criteria

Inclusion Criteria

- Clinical stroke syndrome with limb paresis, not likely to represent a transient ischaemic attack or non-stroke pathology (e.g. cerebral tumour)
- Systolic blood pressure ≥ 140 mm Hg
- Trial treatment possible within 30 hrs of symptom onset. If time of onset is not known, use the time when the patient was last known to be well.
- Consent (subsidiary, assent from legal acceptable representative, or waiver of consent)
- Age >18 years

Exclusion Criteria

- Markedly reduced consciousness (i.e. Scandinavian Stroke Scale consciousness score ≤ 2)
- Patient already receiving AT1 receptor blocker
- Contraindication to treatment with AT1 receptor blocker, e.g.:
- known renal failure (women: creatinine ≥ 150 µmol/L; men: ≥ 180 µmol/L)
- previously diagnosed bilateral renal artery stenosis
- previously diagnosed high-grade aortic stenosis
- previously diagnosed seriously impaired liver function and/or cholestasis
- known intolerance to candesartan or other tablet ingredients
- Clear indication, in the clinician's view, for start of treatment with AT1 receptor blocker during the treatment period (e.g. chronic heart failure grade III-IV, in the presence of intolerance to ACE inhibitors)
- Clear indication, in the clinician's view, for antihypertensive therapy during the acute phase of stroke (i.e. concurrent hypertensive encephalopathy or aortic dissection, or other situations)
- Other serious or life-threatening disease before the stroke:
- Patient severely mentally or physically disabled (e.g. Mini Mental Status score < 20, or modified Rankin Scale score ≥ 4)
- Life expectancy < 12 months
- Patient unavailable for follow-up (e.g. no fixed address)
- Pregnant or breast-feeding woman