Faculty

Dr. Oscar Benavente

Dr. Benavente received his medical degree from the National University of Cordoba in Argentina. He completed neurology residency and fellowship training at the Universities of Western Ontario and Ottawa in Canada, followed by a Stroke Fellowship at the University of Texas in San Antonio (UTHSCSA).

Dr. Benavente held staff neurologist positions at UTHSCSA until 2009, during which time he also became a Professor in the Department of Neurology and Director of the Stroke Program. In 2009 he relocated to the University of British Columbia in Vancouver where he is currently Professor and the Research Director of the Stroke and Cerebrovascular Health Program. Dr. Benavente specializes in cerebrovascular disease, particularly secondary stroke prevention, and is actively engaged in clinical trials research in this area. Most significantly, he is the Principal Investigator of the recently completed, funded by the National Institute of Health of US/NINDS, Secondary Prevention of Small Subcortical Strokes study (SPS3 trial), the largest clinical trial to date investigating optimal antiplatelet therapy and hypertension management for lacunar stroke patients. Over 3000 participants were recruited in 8 countries between 2003 and 2012.

Dr. Benavente is certified by the American Board of Psychiatry and Neurology (Neurology and Vascular Neurology) and is a Fellow of The Royal College of Physicians and Surgeons of Canada. Over the length of his career he has authored more than 70 peer-reviewed publications and presented at numerous international conferences, including the American Heart Association International Stroke Conference and the European Stroke Conference. He has been a peer-reviewer for multiple publications and has been a member of several DSMB committees for stroke clinical trials. He supports developing and encouraging promising clinician-scientists and currently supervises several post-graduate fellows and medical students.

1. Amarenco P, Goldstein LB, Sillesen H, Benavente O, et al. Coronary heart disease risk in patients with stroke or transient ischemic attack and no known coronary heart disease: findings from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Stroke 2010;41:426-30.

2. Elkind MS, Luna JM, Coffey CS, et al. The Levels of Inflammatory Markers in the Treatment of Stroke study (LIMITS): inflammatory biomarkers as risk predictors after lacunar stroke. Int J Stroke 2010;5:117-25.

3. Benavente OR, White CL, Pearce L, et al. The Secondary Prevention of Small Subcortical Strokes (SPS3) study. Int J Stroke 2011;6:164-75.

4. Field TS, Benavente OR. Penetrating artery territory pontine infarction. Rev Neurol Dis 2011;8:30-8.

5. Field TS, Benavente OR. Current status of antiplatelet agents to prevent stroke. Curr Neurol Neurosci Rep 2011;11:6-14.

6. Yip S, Benavente O. Antiplatelet agents for stroke prevention. Neurotherapeutics 2011;8:475-87.

7. Shoamanesh A, Kwok CS, Benavente O. Cerebral Microbleeds: Histopathological Correlation of Neuroimaging. Cerebrovasc Dis 2011;32:528-34.

8. White CL, McClure LA, Wallace PM, Benavente OR. The correlates and course of depression in patients with lacunar stroke: results from the Secondary Prevention of Small Subcortical Strokes (SPS3) study. Cerebrovasc Dis 2011;32:354-60.

9. Saver JL, Warach S, Scott J, Odenkirchen J, Becker K, Benavente O., et.al. Standardizing the Structure of Stroke Clinical and Epidemiological Research Data. The National Institute of Neurological Disorders (NINDS) Stroke Common Data Element (CDE) Project. Stroke. 2012 Apr;43(4):967-73

10. White CL, Szychowski JM, Roldan A, Benavente MF, Pretell EJ, Del Brutto OH, Kase CS, Arauz A, Meyer BC, Meissner I, Demaerschalk BM, McClure LA, Coffey CS, Pearce LA, Conwit R, Irby LH, Peri K, Pergola PE, Hart RG, Benavente OR; SPS3 Investigators. Clinical Features and Racial/Ethnic Differences among the 3020 Participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial. J Stroke Cerebrovasc Dis. 2012 Apr 17.

11. Graves JW, White CL, Szychowski JM, Pergola PE, Benavente OR, Coffey CS, Hornung LN, Hart RG; for the SPS3 Study Investigators. Predictors of lowering SBP to assigned targets at 12 months in the Secondary Prevention of Small Subcortical Strokes study. J Hypertens. 2012 Jun;30(6):1233-1240.

12. Palacio S, Hart RG, Pearce LA, Benavente OR. Effect of addition of clopidogrel to aspirin on mortality: systematic review of randomized trials. Stroke 2012 Aug;43 (8): 2157-62

13. McClure LA, Szychowski JM, Benavente O, Coffey CS. Sample size re-estimation in an on-going NIH-sponsored clinical trial: The secondary prevention of small subcortical strokes experience. Contemp Clin Trials. 2012 Sep;33(5):1088-93

14. Benavente OR, McClure LA, Coffey CS, Szychowski JM, Hart RG. Effects of Clopidogrel Added to Aspirin in Patients with Recent Lacunar Stroke. The SPS3 Investigators. N Engl J Med. 2012;367:817-825.

15. Jacova,Claudia; Pearce,Lesly A.; Costello,Raymond; McClure,Leslie A.; Holliday,Stephen L.; Hart,Robert G.; Benavente,Oscar R. Cognitive impairment in strokes: The SPS3 trial. Ann Neurol. 2012;72:351-362.

16. Jodi D. Edwards, Claudia Jacova, Amir A. Sepehry, Brandy Pratt, and Oscar R. Benavente. A quantitative systematic review of domain-specific cognitive impairment in

lacunar stroke. Neurology 2013 80:1-8.

17. Shoamanesh A, Kwok CS, Benavente OR. Post-Thrombolysis Intracranial Hemorrhage of Cerebral Microbleeds: A Systematic Review and Meta-analysis. Int J Stroke. 2013 Jul;8(5):348-56

18. Palacio S, Hart RG, Pearce LA, Anderson DC, Sharma M, Birnbaum LA, Benavente OR. Effect of addition of clopidogrel to aspirin on stroke incidence: Meta-analysis of randomized trials. Int J Stroke. 2013 May 22.

19. Benavente OR, Coffey CS, Conwit R, Hart RG, McClure LA, Pearce LA, Pergola PE, Szychowski. Blood pressure targets in patients with recent lacunar stroke: the SPS3 randomized trial. Lancet 2013 Aug 10;382:507-15.

20. White CL, Pergola PE, Szychowski JM, Talbert R, Cervantes-Arriaga A, Clark HD, Del Brutto OH, Godoy IE, Hill MD, Pelegrí A, Sussman CR, Taylor AA, Valdivia J, Anderson DC, Conwit R, Benavente OR; for the SPS3 Investigators. Blood Pressure After Recent Stroke: Baseline Findings From the Secondary Prevention of Small Subcortical Strokes Trial. Am J. Hypertens, 2013;26:1114-1122.

21. Field TS, Nakajima M, Benavente OR. Combination aspirin and clopidogrel for secondary prevention of ischemic stroke. Curr Treat Options Cardiovasc Med. 2013 Jun;15(3):348-59.

22. Hart RG, Pearce LA, Bakheet MF, Benavente OR, Conwit RA, McClure LA, Talbert RL, Anderson DC. Predictors of Stroke Recurrence in Patients with Recent Lacunar Stroke and Response to Interventions According to Risk Status: Secondary Prevention of Small Subcortical Strokes Trial. J Stroke Cerebrovasc Dis 2013 June 22.

23. Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, Frayne R, Lindley RI, O’Brien JT, Barkhof F, Benavente OR, et. al. STandards for ReportIng Vascular changes on nEuroimaging (STRIVE v1). Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013 Aug;12(8):822-38.

24. Meschia JF, Arnett DK, Ay H, Brown RD Jr, Benavente OR, et. al. on behalf of the NINDS SiGN Study; Stroke Genetics Network (SiGN) Study: Design and Rationale for a Genome-Wide Association Study of Ischemic Stroke Subtypes. Stroke. 2013 Oct;44(10):2694-2702.

25. Wilson LK, Benavente OR, Woolfenden AR, Asdaghi N. Spontaneous limb movements and posturing secondary to acute basilar artery occlusion: a potentially devastating seizure mimic. Pract Neurol. 2013 Sep 17.

26. Dhamoon MS, McClure LA, White CL, Lau H, Benavente O, Elkind MS. Quality of life after lacunar stroke: The Secondary Prevention of Small Subcortical Stroke Study. J Stroke Cerebrovasc Dis. 2013 Oct 28

27. Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randomised trial. The SPS3 Study Group. Benavente OR, Coffey CS, Conwit R, Hart RG, McClure LA, Pearce LA, Pergola PE, Szychowski JM. Lancet 2013; 382:507-15

28. Côté R, Zhang Y, Hart RG, McClure LA, Anderson DC, Talbert RL, Benavente OR. ASA failure. Does the combination ASA/clopidogrel confer better long-term vascular protection? Neurology 2014;821-8.

29. Lewis BL, Pearce LA, Field TS, White CL, Benavente OR, on behalf of the SPS3 Investigators. The Relevance of Living Supports on Antiplatelet Adherence and Trial Participation: The SPS3 Trial. Int J Stroke 2014 Jun ;9 (4):443-8

30. Elkind MSV, Luna JM, McClure LA, Zhang Y, Coffey CS, Roldan A, Del Brutto OH, Pretell EJ, Pettigrew LC, Meyer BC, Tapia J, White C, Benavente OR, on behalf of the LIMITS Investigators. C-Reactive Protein as a Prognostic Marker After Lacunar Stroke: Levels of Inflammatory Markers in the Treatment of Stroke Study. Stroke. 2014;45:707- 716

31. Pergola PE, White CL, Szychowski JM, Talbert R, del Brutto O, Castellanos M, Graves GW, Matamala G, Pretell EJ, Yee J, Rebello R, Zhang Y, Benavente OR for the SPS3 Investigators. Achieved Blood Pressures in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study: Challenges and Lessons Learned. Am J Hypertens 2014 March 7;27:1052-60

32. Benavente OR, Pearce LA, Bazan C, Roldan AM, Catanese L, Bhat Livezey VM, Pergola-Vidal G, McClure LA, Hart RG for the SPS3 Investigators. Clinical – MRI correlations in lacunar infarcts: The Secondary Prevention of Small Subcortical Strokes (SPS3) Trial. Int J Stroke 2014;9:1057-1064

33. Palacio S, McClure LA, Benavente OR, Bazan C 3rd, Pergola P, Hart RG. Lacunar strokes in patients with diabetes mellitus: risk factors, infarct location and prognosis: The Secondary Prevention of Small Subcortical Strokes Study. Stroke 2014; 45:2689-94

34. Sharma M, Pearce LA, Benavente OR, Anderson DC, Connolly SJ, Palacio S, Coffey CS, Hart RG. Predictors of Mortality in Patients With Lacunar Stroke in the Secondary Prevention of Small Subcortical Strokes Trial. Stroke 2014:45:2989-94

35. Asdaghi N, Pearce LA, Nakajima M, Field TS, Bazan C, Cermeno F, McClure LA, Anderson DC, Hart RG, Benavente OR. Clinical correlates of infarct shape and volume in lacunar strokes. The SPS3 Trial. Stroke. 2014;45:2952-2958

36. Pearce LA, McClure LA, Anderson DC, Jacova C, Sharma M, Hart RG, Benavente OR. Effects of long-term blood pressure lowering and dual antiplatelet therapy on cognition in patients with recent lacunar stroke: Secondary Prevention of Small Subcortical Stroke (SPS3) trial. Lancet Neurology;2014;13:1177-1185

37. Kamal N, Benavente O, et al. Good is not Good Enough: The Benchmark Stroke Door-to-Needle Time Should be 30 Minutes. Can J Neurol Sci. 2014 Nov;41 (6):694-6.

38. Field TS, McClure LA, White CL, Pergola PE, Hart RG, Benavente OR, Hill MD; on behalf of the SPS3 Investigators. Should blood pressure targets after lacunar stroke vary by body size? The SPS3 trial. Am J Hyperten 2014, Dec 1 [Epub]

39. Dhamoon SD, McClure LA, White CA, Lakshminarayan K, MD, Benavente OR, Elkind, M. Long-term disability after lacunar stroke: Secondary Prevention of Small Subcortical Strokes. Neurology. 2015 Mar 10;84 (10):1002-8

40. Jacova C, Pearce LA, Roldan AM, Arauz A, Tapia J, Costello R, McClure LA, Hart RG, Benavente OR. Cognitive performance following lacunar stroke in Spanish-speaking patients: Results from the SPS3 trial. Int J Stroke. Accepted for publication January 6, 2015.

41. Kwok CS, Shoamanesh A, Copley H, Myint P, Loke Y, Benavente OR. Efficacy of antiplatelet therapy in secondary prevention following lacunar stroke: pooled analysis of randomized trials. Stroke. February 26 2015.

42. Smith EE, O’Donnell M, Dagenais G, Lear SA, Wielgosz A, Sharma M, Poirier P, Stotts G, Black SE, Strother S, Noseworthy MD, Benavente O, et. al. PURE Investigators. Early cerebral small vessel disease and brain volume, cognition and gait. Ann Neurol. 2015 Feb;77 (2):251-61.

CHAPTERS:

1. Benavente O, Barnett H.J.M. Spinal Cord Infarction. Chapter 69, in Carter L.P.;Spetzler R.F. (editors). Neurovascular Surgery, McGraw-Hill, Inc.1995.

2. Benavente O, Barnett HJM. Spinal Cord Ischemia, Chapter 28 in Barnett HJM, Mohr JP, Stein BM and Yatsu FM (editors). Stroke Pathophysiology, Diagnosis and Management. Third edition, Churchill Livingston, 1998.

3. Benavente O, Hart RG, Sherman DG. Primary Prevention of Transient Ischemic Attack and Thromboembolic Stroke, in Verstraete M, Fuster V, Topol E, (editors). Cardiovascular Thrombosis: Thrombocardiology and Thromboneurology. Chapter 34, Lippincott-Raven, Philadelphia-New York 1998.

4. Sherman DG, Benavente O. Clinicals Trials for Stroke: Design Considerations, in Miller LP (editor), Stroke Therapy: Basic, Preclinical and Clinical Directions. Chapter 13, Wiley-Liss, Inc. 1999.

5. Benavente O, Hart RG. Anticoagulants for Prevention of Cardioembolic Stroke in Shuaib A, Goldstein L (editors). Management of Acute Stroke Chapter 23, Marcel Dekker, Inc 1999.

6. Benavente O, del Zoppo G, Hart RG. Antithrombotic and thrombolytic treatment of cerebrovascular disease. Chapter in Hirsh J (editor) Hemostasis and Thrombosis, four edition, 2000.

7. Benavente O, Hart RG. Antithrombotic Therapy for Stroke Prevention. Guest Editors. Seminars in Cerebrovascular Diseases and Stroke. 2003; Vol 3, No 1

8. Benavente OR, Sherman D. Secondary Prevention of Cardioembolic Stroke. Chapter 60 in Stroke: Pathophysiology, Diagnosis, and Management, Fourth Edition. Mohr JP, Choi D, Grotta J, Weir B, Wolf P (Editors). Churchill Livingstone 2004.

9. Mohr JP, Benavente OR, Barnett HJM. Spinal Cord Ischemia. Chapter 16 in Stroke: Pathophysiology, Diagnosis, and Management, Fourth Edition. Mohr JP, Choi D, Grotta J, Weir B, Wolf P (Editors). Churchill Livingstone 2004.

10. Benavente, OR. Small Vessel Occlusive Disease, chapter 7 in Prevention and Treatment of Ischemic Stroke (Blue Books of Practical Neurology). Kasner S and Gorelick P (Editors) Elsevier Inc, 2004.

11. Tonarelli SB, Benavente OR. Heritable Connective Tissue Disease. Chapter 88 in The Interface of Neurology & Internal Medicine. Biller J, (Editor). Lippincott Williams & Wilkins 2008.

12. Castellanos M, Babette BW, Benavente OR. Antiplatelet Therapy for Secondary Prevention of Stroke. Chapter 58 in Stroke: Pathophysiology, Diagnosis and Management, Fifth Edition. Mohr JP, Wolf, PA, Grotta JC, Moskowitz, MA, Mayberg MR, von Kummer R (Editors). Elsevier 2011.

13. Aguilar MI, Benavente OR. Secondary Prevention of Cardioembolic Stroke. Chapter 59 in Stroke: Pathophysiology, Diagnosis and Management, Fifth Edition. Mohr JP, Wolf, PA, Grotta JC, Moskowitz, MA, Mayberg MR, von Kummer R (Editors). Elsevier 2011.

14. Field TS, Benavente OR. Secondary Stroke Prevention. Chapter 15. Norrving B. (Editor). Oxford University Press 2014.

15. Nakajima, M, Field TS, Benavente OR. Treatment Approaches for Lacunar Strokes. Chapter 26 in Cerebral Small Vessel Disease. Pantoni L & Gorelick PB (Editors). Cambridge University Press 2014.

16. Field TS, Castellanos M, Babette BW, Benavente OR. Antiplatelet Therapy for Secondary Prevention of Stroke. Chapter # in Stroke: Pathophysiology, Diagnosis and Management, Sixth Edition. Mohr JP, Wolf, PA, Grotta JC, Moskowitz, MA, Mayberg MR, von Kummer R (Editors). Elsevier In press (2014).