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Currently, you can access the following clinical trials being conducted worldwide:

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Clinical trial information and results are updated daily from ClinicalTrials.gov. The latest data update was conducted on 06/14/2021.
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Clinical trial information and results are updated daily from ClinicalTrials.gov. The latest data update was conducted on 06/14/2021.

Evolution of Ischemic Stroke Subtypes in Hong Kong

Clinicaltrials.gov identifier NCT03936439

Recruitment Status Completed

First Posted May 3, 2019

Last update posted June 9, 2020

Study Description

Brief summary:

Stroke is the 4th leading cause of mortality in Hong Kong. It also carries considerable socioeconomical consequences due to disability. Ischemic stroke can be classified by the TOAST classification, which includes large artery atherosclerosis, cardioembolism, small-artery occlusion and other causes (1). Among which, intracranial atherosclerosis (ICAS) had been major cause of acute ischemic stroke (AIS) in the Asia Pacific. It was estimated as high as 24.1% of AIS or transient ischemic attacks (TIAs) were attributed to ICAS in China (2). Management of ICAS related strokes has been challenging owing to its high rate of recurrence despite medical therapy. Recent randomized clinical trial suggested that aggressive medical therapy may result in reduction in recurrence compared with historical cohorts (3). Our group has previously observed a 2.5-fold increase in atrial fibrillation related stroke over a 15-year period (4). The inverstigator also observed a decline in ICAS related AIS as well as its recurrent stroke risk throughout the recent years. Possible mechanisms include better management of metabolic risk factors and aggressive secondary prevention. Other possible reasons are increased atrial fibrillation (AF), small vessel disease (SVD) or other stroke mechanisms. This study is aim to find the evolution of different stroke subtypes in relation to the characteristics of our stroke population over a 15-year period. This may influence territorial prevention strategy.

  • Condition or Disease:Neurologic Symptoms
    Stroke
    Stroke, Acute
  • Intervention/Treatment:
  • Phase: N/A
Detailed Description

Five time points, i.e. 2004, 2006, 2008, 2010, 2012, 2014, 2016, 2018 are selected for analysis. All consecutive stroke patients included in the Prince of Wales Hospital stroke registry will be recruited. Patients will be stratified according to their stroke subtypes with reference to the TOAST classification (1), which includes large artery disease, cardioembolism, small vessel occlusion, other determined causes, undetermined cause or incomplete investigations. Stroke etiology is determined by stroke neurologists with reference to the history, physical signs, imaging including carotid duplex, transcranial doppler, computer tomography (CT), CT angiogram, magnetic resonance imaging (MRI), MR angiogram, electrocardiography (ECG) and echocardiography. Interobserver variability for stroke mechanism determination will be evaluated. Pre-defined demographic data including age, gender, smoking status, vascular risk factors including hyperlipidaemia, hypertension, diabetes, prior stroke or TIA, etc. will be retrieved from the stroke registry. The investigator will also compare the use of antiplatelet agents, anticoagulants, lipid-lowering agents, specific antihypertensives in the Shatin territory across the 15-year period using the CDARS.

Study Design
  • Study Type: Observational
  • Actual Enrollment: 10000 participants
  • Observational Model: Cohort
  • Time Perspective: Retrospective
  • Official Title: Evolution of Ischemic Stroke Subtypes in Hong Kong
  • Actual Study Start Date: March 2019
  • Actual Primary Completion Date: October 2019
  • Actual Study Completion Date: October 2019
Outcome Measures
  • Primary Outcome Measures: 1. Prevalence of ischemic stroke subtype in Hong Kong with the advancement of primary care of cardiovascular control. [ Time Frame: 31 Jul, 2019 ]
    Stroke subtypes of the patients in the past 15 years will be classified by the reference of TOAST classification.
  • Secondary Outcome Measures: 1. The changes of stroke etiology in the population over 15-year period in Hong Kong [ Time Frame: 31 Dec, 2019 ]
    Stroke etiology will be determined by the imaging including carotid duplex, transcranial doppler, computer tomography (CT), CT angiogram, magnetic resonance imaging (MRI), MR angiogram, electrocardiography (ECG) and echocardiography.
Eligibility Criteria
  • Ages Eligible for Study: (Child, Adult, Older Adult)
  • Sexes Eligible for Study: All
  • Accepts Healthy Volunteers: No
  • Sampling Method: Non-Probability Sample
  • Study Population: Patients in the stroke registry of the Prince of Wales Hospital in the recent 15 years.
Criteria

Inclusion Criteria:

- All consecutive Chinese stroke patients included in the Prince of Wales Hospital
stroke registry at 2-year intervals, i.e. from 2004 to 2018

Exclusion Criteria:

1. Uncertain diagnosis of stroke

2. Non-Chinese patients

Contacts and Locations
Contacts
Locations

Hong Kong
Chinese University of Hong Kong
Hong Kong

Sponsors and Collaborators

Chinese University of Hong Kong

Investigators

Principal Investigator: Yiu Ming Bonaventure IP, MBChB, MRCP Chinese University of Hong Kong

More Information
  • Responsible Party: Chinese University of Hong Kong
  • ClinicalTrials.gov Identifier: NCT03936439 History of Changes
  • Other Study ID Numbers: crec 2018.645
  • First Posted: May 3, 2019 Key Record Dates
  • Last Update Posted: June 9, 2020
  • Last Verified: June 2020
  • Individual Participant
    Data (IPD) Sharing
    Statement:
  • Plan to Share IPD: No
  • Studies a U.S. FDA-regulated Drug Product: No
  • Studies a U.S. FDA-regulated Device Product: No
  • Keywords provided by Chinese University of Hong Kong: stroke
  • Additional relevant MeSH terms: Neurologic Manifestations Stroke