Document Detail


The Virtual International Stroke Trials Archive (VISTA): results and impact on future stroke trials and management of stroke patients.
MedLine Citation:
PMID:  20446944     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Virtual International Stroke Trials Archive was established to improve stroke care and trial design through the collation, categorization and potential access to data sets from clinical trials for the treatment of stroke. METHODS: Virtual International Stroke Trials Archive currently provides access to a combined data set of 29 anonymised acute stroke trials and one acute stroke registry with data on >27,500 patients aged between 18 and 103 (mean 71) years. RESULTS: Virtual International Stroke Trials Archive has facilitated research across a broad canvas. The prognosis was poor in patients with very high blood pressure at the time of admission or with a wide variability of systolic blood pressure during the acute phase. The late occurrence of hyperthermia following an ischaemic stroke worsens the prognosis. Stroke lateralisation is not an important predictor of cardiac adverse events or 90-day mortality. Haemorrhagic transformation is seen frequently in patients with cardio-embolic strokes and is associated with a poor prognosis when occurring after the acute phase. Virtual International Stroke Trials Archive has allowed various prognostic models for patients with ischaemic or haemorrhagic stroke to be established and validated. More direct outcomes such as lesion volume can be useful in phase II clinical trials for determining whether a phase III trial should be undertaken. New outcome measures such as 'home time' may also strengthen future trials. On a worldwide level, the prognosis of stroke patients differs considerably between various countries. CONCLUSION: Virtual International Stroke Trials Archive provides an excellent opportunity for analysis of natural history data and prognosis. It has the potential to influence clinical trial design and implementation through exploratory data analyses.
Authors:
C Weimar; M Ali; K R Lees; E Bluhmki; G A Donnan; H C Diener;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of stroke : official journal of the International Stroke Society     Volume:  5     ISSN:  1747-4949     ISO Abbreviation:  Int J Stroke     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274068     Medline TA:  Int J Stroke     Country:  England    
Other Details:
Languages:  eng     Pagination:  103-9     Citation Subset:  IM    
Affiliation:
Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. stroke.med@uni-due.de
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / therapeutic use
Archives
Clinical Trials as Topic
Fibrinolytic Agents / therapeutic use
Forecasting
Humans
Hyperthermia, Induced
Neuroprotective Agents / therapeutic use
Patient Selection
Prognosis
Randomized Controlled Trials as Topic
Stroke / drug therapy*,  mortality,  physiopathology,  prevention & control
User-Computer Interface
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents; 0/Neuroprotective Agents
Investigator
Investigator/Affiliation:
K R Lees / ; P M W Bath / ; E Bluhmki / ; M Brady / ; L Claesson / ; J Curram / ; S M Davis / ; H C Diener / ; G A Donnan / ; M Fisher / ; B A Gregson / ; J Grotta / ; W Hacke / ; M G Hennerici / ; M Hommel / ; M Kaste / ; P Lyden / ; J Marler / ; K Muir / ; R L Sacco / ; A Shuaib / ; P Teal / ; N G Wahlgren / ; S Warach / ; C Weimar /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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