Ischemic StrokeST2ROKENCT04607031
Prognostic Accuracy of ST2 Dynamics in Ischemic Stroke Outcome
An observational study of Ischemic Stroke, run by General Hospital Sveti Duh at 1 site in Croatia.
Trial summary
Early outcome prediction after ischemic stroke (IS) is of great importance. Prognosis is usually based on clinical variables and neuroradiological findings while serum biomarkers may contribute to prognostic accuracy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Ischemic Stroke
- What is being tested?
- measurement of serum ST2 concentrations in serum of patients with acute, ischemic stroke
- How many people
- 20 participants
- Where
- 1 siteCroatia
- Study dates
- 10 Sep 2019to 31 Mar 2021
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: The target population will be patients with ischemic stroke. The available population to be sampled will be patients with ischemic stroke admitted to the Neurology Department with a confirmed diagnosis of ischemic stroke by two experienced neurologists
Who may be able to join
- onset of symptoms within 24 hours, initial NIHSS≥8 including patients with major blood vessel occlusion who will not be transferred for intervention (due to insufficient collateral, demarcated infarction or other reasons) and consent of the patient or legal representative or guardian
Who cannot join
- unknown time of onset of symptoms, duration of symptoms longer than 24 hours, conditions of patients in which, according to the responsible specialist neurologist, additional blood sampling could have an adverse effect on the outcome of the disease, administration of thrombolytic therapy and the presence of the following associated conditions: myocardial infarction, heart failure, malignancy, immune disease, severe infection and pregnancy. The study would exclude subjects diagnosed with transient ischemic attack, MU-like conditions, urgently transferred to another institution for invasive treatment, and patients with MU caused by rare diseases (eg, Fabry's disease, dissections, coagulopathies, etc.)
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Prognostic Accuracy of Suppression of Tumorigenicity 2 Dynamics in Ischemic Stroke Outcome
Early outcome prediction after ischemic stroke (IS) is of great importance. Prognosis is usually based on clinical variables and neuroradiological findings while serum biomarkers may contribute to prognostic accuracy. Inflammatory biomarker Suppression of Tumorigenicity 2 (ST2) has been shown as promising in IMU outcome predicting. The relationship between ST2 serum values and IS severity is not fully clarified. The proposed hypothesis is that earlier releasing and higher ST2 serum concentrations will be associated with a worse IS outcome. In this prospective and observational study 20 patients with IS will be included and followed. The primary outcome is functional outcome according to the modified Ranking scale at 90 days. In case of hypothesis confirmation, theoretical contribution will be in a better understanding of pathophysiological changes in acute phase of IS, while the clinical purpose is to improve the prognostic procedure.
Read the detailed description
The following data will be collected for all participants: 1. concentration of ST2 biochemical markers, 2. concentration of routine biochemical and hematological tests, 3. prognostic indices of PNI and GPS, 3. sex, 4. age, 5. body weight, 6. body visa, 7. body mass index (BMI), 8. NIHSS, 9. volume of brain infarction, 10. exact time of onset of symptoms, 11. smoking, 12. excessive alcohol drinking, 13. drug abuse, 14. arterial hypertension, 16. atrial fibrillation, 17. presence of cardiac valve, 18. dyslipidemia, 19. diabetes, 20. coronary disease, 21. liver dysfunction, 22. renal dysfunction, 23. peripheral arterial disease, 24. pre-existing stroke / transient ischemic attack, 25. positive family history, 26. complication of IS, 27. etiology of IS according to TOAST (criteria Trial of Org 10172 in Acute Stroke Treatment) criteria, 28. localization of MU according to OCSP (Oxfordshire Community Stroke Project) projects. Procedures: Laboratory parameters will be measured at seven time points, monitored once daily for six consecutive days, and will include: complete blood count, glucose concentration, sodium, urea, creatinine, C - reactive protein, total and direct bilirubin, total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol, urate, total protein, albumin, eGFR (estimated glomerular filtration rate) and alanine aminotransferase enzyme activities, aspartate aminotransferase and gamma-glutamyl transpeptidase. The prognostic indices of PNI (formula that includes albumin and leukocyte count) and GPS (formula that includes CRP and albumin) will be calculated. The size of the IS will be analyzed on the basis of computed tomography (CT) of the brain and CT of the brain volumetry according to Pullicino formulas, in patients who will undergo brain CT initially and at least 20-24 hours apart. The IS classification will enforce the use of the TOAST and OCSP criteria. The severity of IS will be clinically assessed using the NIHSS scale at hospital admissions and during each subsequent point in the study timeline. Stroke outcomes will be assessed using mRS on day 6 and day 90 (+/- 7 days) with a comparison of disability on the same rating scale before hospitalization. Sampling will be done during regular business hours and on duty (0-24 hours). Blood will be drawn by the nurse / technician from the ante-cubital vein according to EFML-COABIOCLI guidelines. From the remaining blood samples routinely taken as part of the patient's regular treatment, concentrations of biochemical markers will be determined. In addition, at those time points (up to 6) at which blood is not excluded during laboratory processing for laboratory testing, this will be done for the purposes of this research. The maximum amount of additionally excluded blood for the purposes of this study will therefore be 48 mL. Analysis of routine laboratory parameters will be performed immediately after sampling. Part of the serum will be stored at -20 ° C for subsequent analysis of the concentration of the biochemical marker ST2. Laboratory parameters will be determined by the enzyme linked immunosorbent assay method on an automatic analyzer.
- Conditions
- Ischemic Stroke
- Being tested
- measurement of serum ST2 concentrations in serum of patients with acute, ischemic stroke
- Keywords
- ischemic stroke; ST2; prognostic accuracy; outcome
- Medical subject headings
- Ischemic Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
measurement of serum ST2 concentrations in serum of patients with acute, ischemic strokeDiagnostic test
7 measurements of serum ST2 concentrations from day 0 to day 6, modified Rankin scale before, 6th and 90th day, NIHSS from day 0 to day 6 and 90, TOAST and OCSP classifications
| Study group | Role | What they receive |
|---|---|---|
| ischemic stroke patients | 20 patients with ischemic stroke, onset within 24 hours, NIHSS≥8 Receives: Diagnostic Test: measurement of serum ST2 concentrations in serum of patients with acute, ischemic stroke |
What is being measured
The primary outcome is the main question the study is designed to answer.
functional outcome according to the modified Rankin scale
0-1 good outcome and 2-6 poor outcome
Measured: after 90 days:
Secondary outcomes (1)
all-cause mortality
all-cause
Measured: after 90 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Oct 2020
- Study start10 Sep 2019
- Primary completion31 Mar 2020
- Study completion31 Mar 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Ischemic StrokeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 20 participants (actual)
Sponsor and investigators
- Lead sponsor
- General Hospital Sveti Duh
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ana Sruk, General Hospital Sveti Duh
- Investigators
- Ana Sruk, MD, Principal investigator, GH Sveti Duh, Zagreb, Croatia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04607031
- Sponsor's protocol ID
- ST2
- Acronym
- ST2ROKE
- Status last verified
- Jul 2021
- First submitted
- 22 Oct 2020
- Last updated
- 28 Jul 2021
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Jul 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Prognostic Accuracy of Suppression of Tumorigenicity 2 Dynamics in Ischemic Stroke Outcome
- ClinicalTrials.gov ID
- NCT04607031
- Acronym / sponsor ID
- ST2ROKE / ST2
- Conditions
- Ischemic Stroke
- Keywords
- ischemic stroke; ST2; prognostic accuracy; outcome
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 20 participants (actual)
- Lead sponsor
- General Hospital Sveti DuhUniversity, hospital or other
- Study start
- 10 Sep 2019 (actual)
- Primary completion
- 31 Mar 2020 (actual)
- Study completion
- 31 Mar 2021 (actual)
- First posted
- 28 Oct 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Early outcome prediction after ischemic stroke (IS) is of great importance. Prognosis is usually based on clinical variables and neuroradiological findings while serum biomarkers may contribute to prognostic accuracy. Inflammatory biomarker Suppression of Tumorigenicity 2 (ST2) has been shown as promising in IMU outcome predicting. The relationship between ST2 serum values and IS severity is not fully clarified. The proposed hypothesis is that earlier releasing and higher ST2 serum concentrations will be associated with a worse IS outcome. In this prospective and observational study 20 patients with IS will be included and followed. The primary outcome is functional outcome according to the modified Ranking scale at 90 days. In case of hypothesis confirmation, theoretical contribution will be in a better understanding of pathophysiological changes in acute phase of IS, while the clinical purpose is to improve the prognostic procedure.
Detailed description
The following data will be collected for all participants: 1. concentration of ST2 biochemical markers, 2. concentration of routine biochemical and hematological tests, 3. prognostic indices of PNI and GPS, 3. sex, 4. age, 5. body weight, 6. body visa, 7. body mass index (BMI), 8. NIHSS, 9. volume of brain infarction, 10. exact time of onset of symptoms, 11. smoking, 12. excessive alcohol drinking, 13. drug abuse, 14. arterial hypertension, 16. atrial fibrillation, 17. presence of cardiac valve, 18. dyslipidemia, 19. diabetes, 20. coronary disease, 21. liver dysfunction, 22. renal dysfunction, 23. peripheral arterial disease, 24. pre-existing stroke / transient ischemic attack, 25. positive family history, 26. complication of IS, 27. etiology of IS according to TOAST (criteria Trial of Org 10172 in Acute Stroke Treatment) criteria, 28. localization of MU according to OCSP (Oxfordshire Community Stroke Project) projects. Procedures: Laboratory parameters will be measured at seven time points, monitored once daily for six consecutive days, and will include: complete blood count, glucose concentration, sodium, urea, creatinine, C - reactive protein, total and direct bilirubin, total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol, urate, total protein, albumin, eGFR (estimated glomerular filtration rate) and alanine aminotransferase enzyme activities, aspartate aminotransferase and gamma-glutamyl transpeptidase. The prognostic indices of PNI (formula that includes albumin and leukocyte count) and GPS (formula that includes CRP and albumin) will be calculated. The size of the IS will be analyzed on the basis of computed tomography (CT) of the brain and CT of the brain volumetry according to Pullicino formulas, in patients who will undergo brain CT initially and at least 20-24 hours apart. The IS classification will enforce the use of the TOAST and OCSP criteria. The severity of IS will be clinically assessed using the NIHSS scale at hospital admissions and during each subsequent point in the study timeline. Stroke outcomes will be assessed using mRS on day 6 and day 90 (+/- 7 days) with a comparison of disability on the same rating scale before hospitalization. Sampling will be done during regular business hours and on duty (0-24 hours). Blood will be drawn by the nurse / technician from the ante-cubital vein according to EFML-COABIOCLI guidelines. From the remaining blood samples routinely taken as part of the patient's regular treatment, concentrations of biochemical markers will be determined. In addition, at those time points (up to 6) at which blood is not excluded during laboratory processing for laboratory testing, this will be done for the purposes of this research. The maximum amount of additionally excluded blood for the purposes of this study will therefore be 48 mL. Analysis of routine laboratory parameters will be performed immediately after sampling. Part of the serum will be stored at -20 ° C for subsequent analysis of the concentration of the biochemical marker ST2. Laboratory parameters will be determined by the enzyme linked immunosorbent assay method on an automatic analyzer.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| ischemic stroke patients | – | Diagnostic Test: measurement of serum ST2 concentrations in serum of patients with acute, ischemic stroke20 patients with ischemic stroke, onset within 24 hours, NIHSS≥8 |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- The target population will be patients with ischemic stroke. The available population to be sampled will be patients with ischemic stroke admitted to the Neurology Department with a confirmed diagnosis of ischemic stroke by two experienced neurologists
Key inclusion criteria (1 listed)
- onset of symptoms within 24 hours, initial NIHSS≥8 including patients with major blood vessel occlusion who will not be transferred for intervention (due to insufficient collateral, demarcated infarction or other reasons) and consent of the patient or legal representative or guardian
Key exclusion criteria (1 listed)
- unknown time of onset of symptoms, duration of symptoms longer than 24 hours, conditions of patients in which, according to the responsible specialist neurologist, additional blood sampling could have an adverse effect on the outcome of the disease, administration of thrombolytic therapy and the presence of the following associated conditions: myocardial infarction, heart failure, malignancy, immune disease, severe infection and pregnancy. The study would exclude subjects diagnosed with transient ischemic attack, MU-like conditions, urgently transferred to another institution for invasive treatment, and patients with MU caused by rare diseases (eg, Fabry's disease, dissections, coagulopathies, etc.)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| measurement of serum ST2 concentrations in serum of patients with acute, ischemic stroke7 measurements of serum ST2 concentrations from day 0 to day 6, modified Rankin scale before, 6th and 90th day, NIHSS from day 0 to day 6 and 90, TOAST and OCSP classifications | Diagnostic test | ischemic stroke patients |
Primary outcome
functional outcome according to the modified Rankin scale
Time frame: after 90 days:
0-1 good outcome and 2-6 poor outcome
1 secondary outcome
all-cause mortality
Time frame: after 90 days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Jul 2021.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ana Sruk, MD principal investigator
GH Sveti Duh, Zagreb, Croatia
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Ischemic Stroke, run by General Hospital Sveti Duh at 1 site in Croatia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 28 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Croatia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
functional outcome according to the modified Rankin scale (time frame: after 90 days:). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jul 2021.