ESOC 2026 | Secondary analysis of TRIDENT: functional outcomes, quality of life, and cognitive outcomes

So the TRIDENT trial results were presented at the World Stroke Organization Congress in Barcelona last October 2025. And the main results have been published in the New England Journal of Medicine in April 2026. The presentation at ESOC relates to pre-specified secondary outcomes related to functional recovery, modified Rankin scale and quality of life and also the cognitive outcomes, dementia and mild cognitive impairment and cognitive decline according to standard diagnostic procedures. And on both of these secondary outcomes, there were neutral results. Difficult to explain because the overall results were tried and showed a very strong benefit for the prevention of stroke, and you’d expect then if you’re preventing stroke, you’re preventing disability, but that didn’t translate into those expected findings. The issues around dementia and cognitive decline, probably easier to explain. We did an MRI sub-study, which showed a very small background prevalence of cerebral small vessel disease in the population, which would tend to be younger, average age of 57, predominantly hypertension. And so maybe it’s a lower risk group. And also it’s been very difficult across cardiovascular trials to show a clear benefit of the treatment on dementia outcomes so probably not too surprising. So overall secondary analysis of the TRIDENT related to functional outcome, quality of life, and cognitive outcomes all neutral.

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