What is a CRISP (Clinical Research Investigating Stroke Prevention) study?

From the Guidelines

The most effective strategy for preventing stroke is to identify and manage modifiable risk factors, with a particular focus on inflammation and infection, as evidenced by the 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack 1. The relationship between inflammation and stroke risk is well-established, with several serum markers of inflammation, including high-sensitivity C-reactive protein (hs-CRP), being proposed as risk markers 1. Some key points to consider in preventing stroke include:

• The use of hs-CRP as a risk marker, particularly in individuals with moderate risk for coronary disease (10% to 20% 10-year risk using the Framingham Risk Score) 1
• The potential benefits of statin therapy in reducing cardiovascular end points, including stroke, in individuals with elevated hs-CRP levels 1
• The importance of managing chronic inflammatory diseases, such as rheumatoid arthritis and systemic lupus erythematosus, which are associated with an increased risk of cardiovascular disease, including stroke 1
• The role of influenza vaccination in reducing the risk of stroke, particularly in older adults, with a prospective study in Taiwan finding a 65% reduction in stroke risk (HR, 0.35; 95% CI, 0.27 to 0.45) 1 The 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack provides evidence-based recommendations for the prevention of ischemic stroke, including the use of antithrombotic therapy, management of modifiable risk factors, and consideration of invasive procedures, such as carotid endarterectomy or angioplasty and stenting 1. Overall, a comprehensive approach to preventing stroke should include identification and management of modifiable risk factors, consideration of anti-inflammatory and antithrombotic therapies, and vaccination against influenza.

From the Research

CRISP Study Overview

• The CRISP study is not directly mentioned in the provided evidence, however, the studies provided offer insights into antibiotic treatment durations and clinical recommendations.
• The studies discuss the effectiveness of shorter versus longer durations of antibiotic therapy for various infections, including bloodstream infections, Staphylococcus aureus infections, and infections associated with bacteremia 2, 3, 4, 5.

Antibiotic Treatment Durations

• A study published in The New England Journal of Medicine found that antibiotic treatment for 7 days was noninferior to treatment for 14 days in patients with bloodstream infections 2.
• Another study published in BMC Infectious Diseases found that partial oral antibiotic therapy was associated with a higher risk of lack of treatment completion compared to all intravenous therapy for serious Staphylococcus aureus infections 4.
• A multicenter, propensity-weighted cohort study published in Clinical Infectious Diseases found that shorter courses of antibiotic treatment (5-9 days) were not associated with increased overall risk of clinical failure compared to longer courses (10-15 days) for infections associated with bacteremia 5.

Clinical Recommendations

• A study published in the European Journal of Pediatrics found that weekly ward rounds led by pediatric infectious diseases specialists in a pediatric intensive care unit resulted in good compliance with clinical recommendations 3.
• An article published in The Journal of Clinical Ethics proposed a framework for reducing bias and improving the quality of medical decisions, including clinical recommendations 6.