Ischemic StrokeSTAMINANCT04357899
Stroke Research Consortium in Northern Bavaria (STAMINA)
An observational study of Ischemic Stroke, run by University of Erlangen-Nürnberg Medical School at 2 sites in Germany.
Trial summary
Each year, approximately 15 million people suffer a stroke worldwide of which 80% are due to ischemic cerebral infarction. Based on the results of randomized controlled trials, treatment options and patient outcomes in acute ischemic stroke have dramatically improved in recent years. 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?
- thrombolysis therapy, endovascular therapy and decompressive surgery
- Type of treatment
- Pill or oral medicine, Surgery or procedure
- How many people
- 3,769 participants
- Where
- 2 sitesGermany
- Study dates
- 1 Jan 2006to 31 Mar 2020
- 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: Ischemic stroke patients treated within a stroke care network in Northern Bavaria, Germany.
Who may be able to join
- Clinical signs and symptoms consistent with the diagnosis of an acute ischemic stroke
- Presence of large vessel occlusion (as evidenced by CTA, MRA or DSA) and/or intravenous thrombolysis therapy applied
Who cannot join
- Age < 18 years
Trial locations and contacts
2 sites in 1 country.
Germany2 sites
Institut für Neuroradiologie, Universitätsklinikum Erlangen
Erlangen, 91054
Neurologische Klinik, Universitätsklinikum Erlangen
Erlangen, 91054
About this study
Official title: Stroke Research Consortium in Northern Bavaria - STAMINA, a Multicenter Longitudinal Cohort Study on Ischemic Stroke Treatment
Each year, approximately 15 million people suffer a stroke worldwide of which 80% are due to ischemic cerebral infarction. Based on the results of randomized controlled trials, treatment options and patient outcomes in acute ischemic stroke have dramatically improved in recent years. However, these advances in thrombolysis and endovascular therapy need to be established outside controlled trials to optimize stroke management, treatment procedures, patient selection and inter-hospital transfer in clinical practice. This multicenter longitudinal cohort study is based on a large stroke care network in Northern Bavaria, Germany (region of more than 3.5 million inhabitants) to evaluate and improve treatment in ischemic stroke.
Read the detailed description
Methods: This multicenter longitudinal cohort study will include ischemic stroke patients treated within a telemedical stroke care network and patients transferred to tertiary stroke centers for treatment procedures from hospitals outside the telemedical network. Individual patient data are available from two tertiary stroke centers and 24 primary and secondary stroke facilities in Northern Bavaria, Germany. Patients with ischemic stroke transferred to the tertiary stroke centers for treatment procedures - i.e. endovascular therapy or thrombolysis in stroke with an unknown time of onset - and all stroke patients with either large vessel occlusion (LVO) and/or thrombolysis therapy admitted to the University Hospital Erlangen will be integrated from institutional prospective stroke registries. Consecutive patients admitted between January 2006 and December 2019 will be included, an estimated total number of more than 3000 ischemic stroke patients - approximately 1000 patients with LVO receiving endovascular therapy, 1000 patients with LVO not receiving endovascular therapy and 1000 patients without LVO receiving thrombolysis therapy.
Demographic and clinical data including medical history, medication and laboratory results will be obtained by review of medical charts, institutional databases or prospective registries, supplemented by structured interviews on follow-up information or by review of all available medical records. In detail the following parameters will be evaluated: prior medical history (e.g. comorbidities, premorbid functional status, medication), admission status (e.g. NIHSS, GCS, body temperature, arterial blood pressure), cerebral imaging parameters (e.g. Alberta Stroke Program Early CT score [ASPECTS], perfusion volumes, mismatch and collateral status on admission imaging, final infarct volume on follow-up imaging), treatment procedures (e.g. intravenous thrombolysis, endovascular therapy, decompressive surgery), time intervals (e.g. symptom onset or last seen normal until admission, imaging, thrombolysis, groin puncture, recanalization), complications (e.g. hemorrhagic transformation, arterial dissection, distant ischemic stroke), laboratory parameters, clinical and diagnostic follow-up (e.g. neurological status, blood pressure, vascular ultrasound), stroke etiology, secondary prevention (e.g. lipid lowering medication, antiplatelet therapy, anticoagulation) and clinical outcomes (e.g. mortality, modified Rankin Scale).
Ethics Approval: The study was approved by the Institutional Review Board of the Friedrich-Alexander-Universität Erlangen-Nürnberg.
- Conditions
- Ischemic Stroke
- Being tested
- thrombolysis therapy, endovascular therapy, decompressive surgery, multimodal imaging in acute ischemic stroke, transfer of acute stroke patients to tertiary stroke centers
- Keywords
- Thrombolysis, Mechanical thrombectomy, Endovascular procedure, Stroke, Cerebrovascular Disorders, Brain Diseases, Brain Ischemia, Cerebral Infarction, Central Nervous System Diseases, Nervous System Diseases, Vascular Diseases, Cardiovascular Diseases, Tissue Plasminogen Activator, Fibrinolytic Agents, Fibrin Modulating Agents
- Medical subject headings
- Ischemic Stroke, Stroke, Cerebrovascular Disorders, Brain Diseases, Brain Ischemia, Cerebral Infarction, Central Nervous System Diseases, Nervous System Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
thrombolysis therapyDrug
Also called thrombolytic drugs
endovascular therapyProcedure or surgery
decompressive surgeryProcedure or surgery
multimodal imaging in acute ischemic strokeDiagnostic test
transfer of acute stroke patients to tertiary stroke centersProcedure or surgery
initiation of antiplatelets, oral anticoagulation and lipid lowering drugs for secondary preventionDrug
Also called antithrombotic oder lipid lowering drugs
What is being measured
The primary outcome is the main question the study is designed to answer.
Functional Outcome (modified Rankin Scale 0-6)
The Distribution of Scores on the modified Rankin Scale (mRS)
Measured: at day 90
Functional Independence (modified Rankin Scale 0-2)
Proportion of participants with functional independence (mRS 0-2)
Measured: at day 90
Favorable Outcome (modified Rankin Scale 0-1)
Proportion of participants with favorable outcome (mRS 0-1)
Measured: at day 90
Infarct volume
Infarct volume on CT or diffusion-weighted MRI
Measured: at day 5 (±2)
Lesion growth volume
Lesion growth volume between ischemic core on baseline imaging and infarkt volume
Measured: at day 5 (±2)
Intracranial hemorrhage
Rate of intracranial hemorrhage defined according to different criteria (ECASS II, SITS-MOST, NINDS or Parenchymal hemorrhage Type 2) on the 24 hour scan
Measured: at 24 (±6) hours
Recanalization Rates
Recanalization of the primary arterial occlusive lesion (based on ultrasound, clinical and radiological assessment) at 24-hours
Measured: at 24 (±6) hours
Secondary outcomes (6)
Mortality
All cause mortality rate
Measured: at 90 days
Procedure time
Time from groin puncture to first recanalization
Measured: procedure
Door-to-groin puncture time
Time from arrival at the tertiary stroke center to groin puncture
Measured: until 24 hours after admission to the tertiary stroke center or until hospital discharge, whichever came first
Door-to-needle time
Time from hospital arrival to IVT administration
Measured: until 24 hours after admission to the tertiary stroke center or until hospital discharge, whichever came first
Symptom-to-door time
Time from symptom onset to arrival at the first hospital
Measured: until 24 hours after admission to the tertiary stroke center or until hospital discharge, whichever came first
Interhospital transfer time
Time from arrival at the first hospital to arrival at the tertiary stroke center
Measured: until 24 hours after admission to the tertiary stroke center or until hospital discharge, whichever came first
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Apr 2020
- Study start1 Jan 2006
- Primary completion31 Dec 2019
- Study completion31 Mar 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Ischemic StrokeStudies of the same condition, open and under way.
- More trials run by University of Erlangen-Nürnberg Medical SchoolThe sponsor's other registered studies.
- 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
- 3,769 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Erlangen-Nürnberg Medical School
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Stefan Schwab, Principal investigator, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Department of Neurology, GermanyArnd Dörfler, Principal investigator, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Department of Neuroradiology, GermanyBernd Kallmünzer, Principal investigator, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Department of Neurology, GermanyTobias Engelhorn, Principal investigator, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Department of Neuroradiology, Germany
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04357899
- Sponsor's protocol ID
- 33_20B
- Acronym
- STAMINA
- Status last verified
- Apr 2021
- First submitted
- 16 Apr 2020
- Last updated
- 2 Aug 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: Because of local ethics committees restrictions the final decision upon release of the raw data has not been made.
Publications
Macha K, Sembill JA, Muehlen I, Engelhorn T, Doerfler A, Schwab S, Kallmunzer B. IV Thrombolysis for Acute Ischemic Stroke with Unknown Onset in Patients on Oral Anticoagulation. Cerebrovasc Dis. 2025;54(4):499-507. doi: 10.1159/000540552. Epub 2024 Aug 23.
PubMed 39182487Sembill JA, Sprugel MI, Haupenthal D, Kremer S, Knott M, Muhlen I, Kallmunzer B, Kuramatsu JB. Endovascular thrombectomy in patients with anterior circulation stroke: an emulated real-world comparison. Neurol Res Pract. 2024 Jul 25;6(1):37. doi: 10.1186/s42466-024-00331-6.
PubMed 39049127
Study at a glance
From the registry record, last updated by the sponsor on 2 Aug 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Stroke Research Consortium in Northern Bavaria - STAMINA, a Multicenter Longitudinal Cohort Study on Ischemic Stroke Treatment
- ClinicalTrials.gov ID
- NCT04357899
- Acronym / sponsor ID
- STAMINA / 33_20B
- Conditions
- Ischemic Stroke
- Keywords
- Thrombolysis, Mechanical thrombectomy, Endovascular procedure, Stroke, Cerebrovascular Disorders, Brain Diseases, Brain Ischemia, Cerebral Infarction
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 3,769 participants (actual)
- Lead sponsor
- University of Erlangen-Nürnberg Medical SchoolUniversity, hospital or other
- Study start
- 1 Jan 2006 (actual)
- Primary completion
- 31 Dec 2019 (actual)
- Study completion
- 31 Mar 2020 (actual)
- First posted
- 22 Apr 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.
Each year, approximately 15 million people suffer a stroke worldwide of which 80% are due to ischemic cerebral infarction. Based on the results of randomized controlled trials, treatment options and patient outcomes in acute ischemic stroke have dramatically improved in recent years. However, these advances in thrombolysis and endovascular therapy need to be established outside controlled trials to optimize stroke management, treatment procedures, patient selection and inter-hospital transfer in clinical practice. This multicenter longitudinal cohort study is based on a large stroke care network in Northern Bavaria, Germany (region of more than 3.5 million inhabitants) to evaluate and improve treatment in ischemic stroke.
Detailed description
Methods: This multicenter longitudinal cohort study will include ischemic stroke patients treated within a telemedical stroke care network and patients transferred to tertiary stroke centers for treatment procedures from hospitals outside the telemedical network. Individual patient data are available from two tertiary stroke centers and 24 primary and secondary stroke facilities in Northern Bavaria, Germany. Patients with ischemic stroke transferred to the tertiary stroke centers for treatment procedures - i.e. endovascular therapy or thrombolysis in stroke with an unknown time of onset - and all stroke patients with either large vessel occlusion (LVO) and/or thrombolysis therapy admitted to the University Hospital Erlangen will be integrated from institutional prospective stroke registries. Consecutive patients admitted between January 2006 and December 2019 will be included, an estimated total number of more than 3000 ischemic stroke patients - approximately 1000 patients with LVO receiving endovascular therapy, 1000 patients with LVO not receiving endovascular therapy and 1000 patients without LVO receiving thrombolysis therapy.
Demographic and clinical data including medical history, medication and laboratory results will be obtained by review of medical charts, institutional databases or prospective registries, supplemented by structured interviews on follow-up information or by review of all available medical records. In detail the following parameters will be evaluated: prior medical history (e.g. comorbidities, premorbid functional status, medication), admission status (e.g. NIHSS, GCS, body temperature, arterial blood pressure), cerebral imaging parameters (e.g. Alberta Stroke Program Early CT score [ASPECTS], perfusion volumes, mismatch and collateral status on admission imaging, final infarct volume on follow-up imaging), treatment procedures (e.g. intravenous thrombolysis, endovascular therapy, decompressive surgery), time intervals (e.g. symptom onset or last seen normal until admission, imaging, thrombolysis, groin puncture, recanalization), complications (e.g. hemorrhagic transformation, arterial dissection, distant ischemic stroke), laboratory parameters, clinical and diagnostic follow-up (e.g. neurological status, blood pressure, vascular ultrasound), stroke etiology, secondary prevention (e.g. lipid lowering medication, antiplatelet therapy, anticoagulation) and clinical outcomes (e.g. mortality, modified Rankin Scale).
Ethics Approval: The study was approved by the Institutional Review Board of the Friedrich-Alexander-Universität Erlangen-Nürnberg.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Ischemic stroke patients treated within a stroke care network in Northern Bavaria, Germany.
Key inclusion criteria (2 listed)
- Clinical signs and symptoms consistent with the diagnosis of an acute ischemic stroke
- Presence of large vessel occlusion (as evidenced by CTA, MRA or DSA) and/or intravenous thrombolysis therapy applied
Key exclusion criteria (1 listed)
- Age < 18 years
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 |
|---|---|---|
| thrombolysis therapyAlso: thrombolytic drugs | Drug | – |
| endovascular therapy | Procedure or surgery | – |
| decompressive surgery | Procedure or surgery | – |
| multimodal imaging in acute ischemic stroke | Diagnostic test | – |
| transfer of acute stroke patients to tertiary stroke centers | Procedure or surgery | – |
| initiation of antiplatelets, oral anticoagulation and lipid lowering drugs for secondary preventionAlso: antithrombotic oder lipid lowering drugs | Drug | – |
Primary outcome
Functional Outcome (modified Rankin Scale 0-6)
Time frame: at day 90
The Distribution of Scores on the modified Rankin Scale (mRS)
Functional Independence (modified Rankin Scale 0-2)
Time frame: at day 90
Proportion of participants with functional independence (mRS 0-2)
Favorable Outcome (modified Rankin Scale 0-1)
Time frame: at day 90
Proportion of participants with favorable outcome (mRS 0-1)
Infarct volume
Time frame: at day 5 (±2)
Infarct volume on CT or diffusion-weighted MRI
Lesion growth volume
Time frame: at day 5 (±2)
Lesion growth volume between ischemic core on baseline imaging and infarkt volume
Intracranial hemorrhage
Time frame: at 24 (±6) hours
Rate of intracranial hemorrhage defined according to different criteria (ECASS II, SITS-MOST, NINDS or Parenchymal hemorrhage Type 2) on the 24 hour scan
Recanalization Rates
Time frame: at 24 (±6) hours
Recanalization of the primary arterial occlusive lesion (based on ultrasound, clinical and radiological assessment) at 24-hours
6 secondary outcomes
Mortality
Time frame: at 90 days
Procedure time
Time frame: procedure
Door-to-groin puncture time
Time frame: until 24 hours after admission to the tertiary stroke center or until hospital discharge, whichever came first
Door-to-needle time
Time frame: until 24 hours after admission to the tertiary stroke center or until hospital discharge, whichever came first
Symptom-to-door time
Time frame: until 24 hours after admission to the tertiary stroke center or until hospital discharge, whichever came first
Interhospital transfer time
Time frame: until 24 hours after admission to the tertiary stroke center or until hospital discharge, whichever came first
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 2 Aug 2022.
- Derived from this study: PubMed 39182487Macha K, Sembill JA, Muehlen I, Engelhorn T, Doerfler A, Schwab S, Kallmunzer B. IV Thrombolysis for Acute Ischemic Stroke with Unknown Onset in Patients on Oral Anticoagulation. Cerebrovasc Dis. 2025;54(4):499-507. doi: 10.1159/000540552. Epub 2024 Aug 23.
- Derived from this study: PubMed 39049127Sembill JA, Sprugel MI, Haupenthal D, Kremer S, Knott M, Muhlen I, Kallmunzer B, Kuramatsu JB. Endovascular thrombectomy in patients with anterior circulation stroke: an emulated real-world comparison. Neurol Res Pract. 2024 Jul 25;6(1):37. doi: 10.1186/s42466-024-00331-6.
- Individual participant dataSharing planned: Undecided. Because of local ethics committees restrictions the final decision upon release of the raw data has not been made.
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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.
Stefan Schwab principal investigator
Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Department of Neurology, Germany
Arnd Dörfler principal investigator
Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Department of Neuroradiology, Germany
Bernd Kallmünzer principal investigator
Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Department of Neurology, Germany
2 sites 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 University of Erlangen-Nürnberg Medical School at 2 sites in Germany.
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 2 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 2 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Germany. 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 (modified Rankin Scale 0-6) (time frame: at day 90). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04357899, which also lists 2 linked publications.
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 2 Aug 2022.