Stroke Registration of Young Adults in China "REACH"

Not yet recruiting

Phase N/A Results N/A

Trial Description

This is a multi-center, prospective,continuous registry study. The investigators will include 3000 young adult (18-45 years old) patients with confirmed first-ever acute ischemic stroke in China. The main purpose of this study is to build the study cohort of young ischemic stroke patients in China, and to compare the prognosis and stroke recurrence of young patients with different ischemic stroke subtypes. Secondary objectives are trying to find biomarkers of stroke recurrence.

Detailed Description

Approximately 10%-14% of all ischemic strokes occur in young adults ages 18 to 45 years old. Stroke etiology in this population differs by geographic region and has greater heterogeneity than in older individuals. Ascertain the definite etiologic classification in this young patients might be the key point to prevent the stroke recurrence and reduce the stroke burden. Advances in stroke diagnostic tests, particularly neuroimaging, refinement in classification schema. In this multi-center registry study conducted in China, we determine to explore the difference of prognosis and stroke recurrence of young patients with different ischemic stroke subtypes.

Conditions

Interventions

  • Treatment following current guidelines Other
    Intervention Desc: treatment following current guidelines
    ARM 1: Kind: Experimental
    Label: Large artery atherosclerosis(LAA)
    Description: LAA includes atherosclerosis of aortic arch and intra-/extracranial large arteries.
    ARM 2: Kind: Experimental
    Label: Cardiogenic stroke(CS)
    Description: (1) Acute multiple infarcts, especially involving bilateral anterior and/or anterior and posterior circulations that have occurred closely in time; (2) No evidence of atherosclerosis on relevant intracranial or extracranial large arteries; (3) No evidence of other etiologies that can cause multifocal acute ischemic infarcts such as vasculitidies, hemostatic disturbances, and tumorous embolism; (4) Evidence of cardiac disease that has a potential for embolism; (5) If the possibility of aortic arch atherosclerosis has been excluded, CS is definite. Otherwise, the category should be possible CS.
    ARM 3: Kind: Experimental
    Label: Penetrating artery disease(PAD)
    Description: Acute isolated infarct in the territory of one penetrating artery caused by atherosclerosis at the proximal segment of the penetrating arteries or lipohyalinotic degeneration of arterioles is called penetrating artery disease (PAD).
    ARM 4: Kind: Experimental
    Label: Other etiology(OE)
    Description: Evidence of other specific diseases (e.g., vascular related disease, infective disorder, inherited disease, hematological system disorder, vasculitis), that are relevant to the index stroke and can be demonstrated by blood tests, cerebrospinal fluid (CSF) tests, and vascular imaging. The possibility of LAA or CS has been excluded.
    ARM 5: Kind: Experimental
    Label: Undetermined etiology(UE)
    Description: No evidence of any specific potential etiology that is clinically relevant to the index stroke. Multiple: Evidence of more than one potential cause, but difficult to determine which was the relevant cause of the index stroke. Unknown: No determined cause is responsible for the index stroke unless more investigations would be performed. Inadequate evaluation: Routine assessments of intracranial and extracranial arteries or heart are not completed, which makes the etiology undetermined.

Trial Population

Young adult patients who had their first-ever ischemic stroke symptoms within 72 hours and visited one of the 22 participating medical centers in People's Republic of China.

Outcomes

Type Measure Time Frame Safety Issue
Primary Stroke recurrence within 90 days 90 days
Primary Cardiovascular death 1 year
Primary Post-stroke disability 1 year
Secondary Other cardiovascular events 1 year
Secondary Intravascular related operations and surgery 1 year
Secondary Systemic arterial embolic events 1 year
Primary Stroke recurrence 1 year
Secondary Other cardiovascular event 3 months, 6 months and 1 year
Secondary Other systemic embolism 3 months, 6 months and 1 year

Biospecimen Retention:Samples Without DNA - EDTA-blood and serum will be collected for future analysis

Sponsors