SVO70 (Optimal Target Low‐Density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke): Rationale and Study Design

BACKGROUND: Current stroke guidelines lack subtype-specific recommendations for optimal low-density lipoprotein cholesterol targets. Indeed, most lipid-lowering trials have not differentiated between stroke subtypes or focused primarily on large artery atherosclerosis, leaving a gap in evidence for other stroke subtypes, such as small vessel occlusion stroke. This study is designed to evaluate whether intensive lipid-lowering therapy is superior to standard therapy in reducing major adverse cardiovascular events among patients with small vessel occlusion stroke. METHODS: SVO70 (Optimal Target Low-Density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke) is a multicenter, prospective, randomized, open, blinded-end point clinical trial in which adult patients with neuroimaging-confirmed small vessel occlusion stroke within 180 days of randomization will be enrolled. Key exclusion criteria include predefined low-density lipoprotein cholesterol targets for other comorbidities, contraindications to statin, and pregnancy or lactation. Eligible participants will be randomized 1:1 to achieve low-density lipoprotein cholesterol <70 mg/dL (intensive group) or 90 to 110 mg/dL (standard group). The trial aims to enroll 4016 participants over a 2-year recruitment period, with a minimum follow-up of 4 years. The primary end point is the occurrence of major adverse cardiovascular events, defined as cardiovascular death, stroke, and acute coronary syndrome, during the follow-up period. Secondary end points include (1) any stroke, (2) ischemic stroke or transient ischemic attack, (3) hemorrhagic stroke, (4) cardiovascular death, (5) myocardial infarction, (6) all-cause death, and (7) acute coronary syndrome. CONCLUSIONS: This study will provide valuable information for determining optimal low-density lipoprotein cholesterol targets for patients with small vessel occlusion stroke. REGISTRATION: URL: https://ClinicalTrials.gov; Unique Identifier: NCT06649240, Clinical Research Information Service (KCT0009043).

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Journal
Journal of the American Heart Association
Published
2026-04-28
DOI
https://doi.org/10.1161/jaha.125.046824
Primary Topic
Acute Ischemic Stroke Management
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article
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article

SVO70 (Optimal Target Low‐Density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke): Rationale and Study Design

Seong Hwan Ahn, B Kim, Joong Hyun Park, D I Kim et al.
Journal of the American Heart Association
Acute Ischemic Stroke Management
article

SVO70 (Optimal Target Low‐Density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke): Rationale and Study Design

Seong Hwan Ahn, B Kim, Joong Hyun Park, D I Kim, Sang Joon An, H J Kim, Sam Yeol Ha, Taedong Ok, Jeong‐Min Kim, Hyemin Jang, Hye Seon Jeong, Hyung‐Min Kwon, Yeong‐Bae Lee, A Hyun Cho, Jong Yun Lee, Yong Wook Kim, W-K Seo, J H Choi, Youngrok Do, Yo Han Jung, Matthew Chung, Sunhye Jung, Jin‐Man Jung, Seung‐Hoon Lee, Hyo Suk Nam, Han‐Jin Cho, Yang‐Ha Hwang, Mi Sun Oh, Eung‐Joon Lee, Kwang‐Yeol Park, Kyusik Kang, Yoonkyung Chang, Sung‐Il Sohn, Wookjin Yang, Hee‐Kwon Park, Tae‐Jin Song, Seongheon Kim, Jae Guk Kim, Joon‐Tae Kim, Chulho Kim, Dong‐Ick Shin, Mi‐Yeon Eun, Joonsang Yoo, Sungwook Yu, Seong‐Ho Koh, Sang‐Wuk Jeong, Hyun Young Park, Je‐Young Shin, Keun‐Hwa Jung, Yong‐Jin Cho
article en

Abstract

BACKGROUND: Current stroke guidelines lack subtype-specific recommendations for optimal low-density lipoprotein cholesterol targets. Indeed, most lipid-lowering trials have not differentiated between stroke subtypes or focused primarily on large artery atherosclerosis, leaving a gap in evidence for other stroke subtypes, such as small vessel occlusion stroke. This study is designed to evaluate whether intensive lipid-lowering therapy is superior to standard therapy in reducing major adverse cardiovascular events among patients with small vessel occlusion stroke. METHODS: SVO70 (Optimal Target Low-Density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke) is a multicenter, prospective, randomized, open, blinded-end point clinical trial in which adult patients with neuroimaging-confirmed small vessel occlusion stroke within 180 days of randomization will be enrolled. Key exclusion criteria include predefined low-density lipoprotein cholesterol targets for other comorbidities, contraindications to statin, and pregnancy or lactation. Eligible participants will be randomized 1:1 to achieve low-density lipoprotein cholesterol <70 mg/dL (intensive group) or 90 to 110 mg/dL (standard group). The trial aims to enroll 4016 participants over a 2-year recruitment period, with a minimum follow-up of 4 years. The primary end point is the occurrence of major adverse cardiovascular events, defined as cardiovascular death, stroke, and acute coronary syndrome, during the follow-up period. Secondary end points include (1) any stroke, (2) ischemic stroke or transient ischemic attack, (3) hemorrhagic stroke, (4) cardiovascular death, (5) myocardial infarction, (6) all-cause death, and (7) acute coronary syndrome. CONCLUSIONS: This study will provide valuable information for determining optimal low-density lipoprotein cholesterol targets for patients with small vessel occlusion stroke. REGISTRATION: URL: https://ClinicalTrials.gov; Unique Identifier: NCT06649240, Clinical Research Information Service (KCT0009043).

Journal of the American Heart AssociationVol. 15(9)
Inje University (KR), Ulsan College (KR), Gachon University (KR), Ewha Womans University (KR), Hallym University (KR), Yonsei University (KR), Korea University (KR), Eulji University (KR), Samsung (South Korea) (KR), Severance Hospital (KR), Seoul Metropolitan Government (KR), Kyungpook National University Hospital (KR), Asan Medical Center (KR), Samsung Medical Center (KR), New Generation University College (ET), Seoul National University Hospital (KR), Seoul National University Bundang Hospital (KR), University of Ulsan (KR), Daegu Catholic University Medical Center (KR), Gyeongsang National University Hospital (KR), Konkuk University Medical Center (KR), Chonnam National University Hospital (KR), Chosun University Hospital (KR), Dongguk University Ilsan Hospital (KR), Inje University Ilsan Paik Hospital (KR), Kangwon National University Hospital (KR), Kyung Hee University Medical Center (KR), Pusan National University Hospital (KR), National University College (PR), Hanyang University Guri Hospital (KR), National Health Insurance Service Ilsan Hospital (KR), Hanyang University Seoul Hospital (KR), Chungnam National University Hospital (KR), Gangnam Severance Hospital (KR), Kangdong Sacred Heart Hospital (KR), National Medical Center (KR), Catholic Kwandong University International St. Mary's Hospital (KR), Inha University Hospital (KR), Chung-Ang University Hospital (KR), National Health Insurance Service (KR), Hallym University Sacred Heart Hospital (KR), Chungbuk National University Hospital (KR), Hallym University Chuncheon Sacred Heart Hospital (KR), Jeju National University Hospital (KR), Keimyung University (KR), Wonkwang University (KR), Sungkyunkwan University (KR), Catholic University of Korea (KR), Catholic Kwandong University (KR)
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Openalex Percentile: Top 17%
Acute Ischemic Stroke Management
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