StrokeBEAT STROKENCT06606054
WSO BEAT STROKE Initiative
A study testing Educational and implementation Neurocardiology tool and No educational or implementation tool will be provided in people with Stroke and PFO - Patent Foramen Ovale, run by Luciano A. Sposato at 1 site in Canada.
Trial summary
The WSO Brain and hEart globAl iniTiative - STROKE (BEAT-STROKE) is a cluster randomized controlled trial, testing whether an educational and implementation Neurocardiology tool can improve adherence to best practice recommendations for secondary stroke prevention of cardioembolic strokes, as defined by the WSO… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Stroke, PFO - Patent Foramen Ovale, Atrial Fibrillation (AF)
- What is being tested?
- Educational and implementation Neurocardiology tool and No educational or implementation tool will be provided
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 2,400 participants
- Where
- 1 siteCanada
- Study dates
- Mar 2027to Dec 2029
- Phase
- Interventional
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
Who may be able to join
- Patients with ischemic stroke or TIA of any etiology.
Who cannot join
- N/A
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Canada1 site
Heart & Brain Lab, Western University
London, Ontario, N6A 5A5
Diana Ayan, Pharm MSc, 519-685-8500 ext. 35826, diana.ayan@lhsc.on.ca
Jennifer Moussa, 519-685-8500 ext. 33110, jennifer.moussa@lhsc.on.ca
About this study
Official title: WSO - The Brain and hEart globAl iniTiative (BEAT) Stroke
The WSO Brain and hEart globAl iniTiative - STROKE (BEAT-STROKE) is a cluster randomized controlled trial, testing whether an educational and implementation Neurocardiology tool can improve adherence to best practice recommendations for secondary stroke prevention of cardioembolic strokes, as defined by the WSO Systematic Review and Synthesis of Global Stroke Guidelines or more recent high-quality evidence published after the last stroke guidelines1
Read the detailed description
The World Stroke Organization (WSO) Brain and Heart Task Force developed The Brain \& hEart globAl iniTiative (BEAT), a pilot feasibility program aimed at establishing clinical collaborations between cardiologists and stroke physicians.1 The WSO BEAT pilot project focused on atrial fibrillation (AF) and patent foramen ovale (PFO) detection and management, highly prevalent cardioembolic causes of ischemic stroke and transient ischemic attack (TIA).
The pilot feasibility WSO BEAT program comprised 10 sites from 8 countries, including Brazil, China, Egypt, Germany, Japan, Mexico, Romania, and the USA. Of the 10 sites, two belonged exclusively to the public sector and one was public and private. The primary objective of the pilot WSO BEAT program was to assess its feasibility by achieving a composite feasibility outcome including: (1) developing site-specific clinical pathways for the diagnosis and management of AF, PFO, and the stroke heart syndrome; (2) establishing regular Neurocardiology rounds (e.g., monthly, bimonthly, etc.); and (3) incorporating a cardiologist to the stroke team.
Overall, the WSO BEAT program successfully achieved the pre-specified goals at most sites. Regarding the three primary program objectives, 9/10 (90%) of the sites were able to design or update the proposed clinical care pathways, establish Neurocardiology rounds, and designate a dedicated cardiologist for the stroke team, respectively.
To date it is unknown whether the implementation of Neurocardiology educational tools and collaborations between cardiologists and neurologists can improve adherence to best practice recommendations focused on the management of cardioembolic strokes.
- Conditions
- Stroke, PFO - Patent Foramen Ovale, Atrial Fibrillation (AF)
- Being tested
- Educational and implementation Neurocardiology tool, No educational or implementation tool will be provided
- Keywords
- cardiac monitoring, stroke, atrial fibrillation, pfo closure
- Medical subject headings
- Stroke, Foramen Ovale, Patent, Atrial Fibrillation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Educational and implementation Neurocardiology toolOther
Sites randomized to the intervention arm will receive an educational and implementation-focused Neurocardiology tool designed to enhance adherence to best practice recommendations for secondary prevention of cardioembolic stroke. These recommendations are based on the World Stroke Organization (WSO) Systematic Review and Synthesis of Global Stroke Guidelines, supplemented by any high-quality evidence published after the most recent stroke guidelines. In addition, participating sites will be provided with 14-day Holter monitors for all patients enrolled in the study.
No educational or implementation tool will be providedOther
Participants in the non-intervention arm will be followed for up to 12 months. Sites randomized to this arm will not receive any educational or implementation tools during the follow-up period. After the 12-month follow-up has been completed, sites may be provided with access to the Neurocardiology tool.
| Study group | Role | What they receive |
|---|---|---|
| No intervention arm - Standard of Care for the institution | Placebo comparator | This group will not receive any of the educational and/or implementation Neurocardiology until the data collection is completed. Receives: Other: No educational or implementation tool will be provided |
| Intervention arm - Educational and implementation Neurocardiology tool | Active comparator | Sites randomized in this arm will receive the educational and implementation Neurocardiology tool with the aim of improving adherence to best practice recommendations for secondary stroke prevention of cardioembolic strokes, as defined by the WSO Systematic Review and Synthesis of Global Stroke Guidelines or more recent high-quality evidence published after the last stroke guidelines. Receives: Other: Educational and implementation Neurocardiology tool |
What is being measured
The primary outcome is the main question the study is designed to answer.
Difference between the baseline and 6-month mean WSO BEAT-STROKE Neurocardiology Score
Difference between baseline and 6-month mean World Stroke Organization Brain and Heart global Initiative Stroke (WSO BEAT-STROKE) Evaluation for Adherence to Treatment Neurocardiology Score
Description: The WSO BEAT-STROKE Neurocardiology Score is a composite scale used to measure adherence to best practice recommendations for the secondary prevention of cardioembolic stroke. It is composed of 8 categories (initial workup, stroke-heart syndrome, ESUS workup, patent foramen ovale, atrial fibrillation management, etc.) with a weighted scoring system (see Table 1).
Scale range: 0 (no adherence) to 10 (full adherence).
Interpretation: Higher scores indicate greater adherence to guideline-recommended care.
Calculation: Each patient's score is calculated by dividing the total points achieved by the total possible points for which the patient is eligible, as not all patients qualify for ESUS, PFO, or AF items.
Measured: 6-months
Secondary outcomes (2)
Difference between the baseline and 6-month mean WSO BEAT-STROKE Neurocardiology Score for each of the 5 pre-specified cathegories.
Difference between baseline and 6-month mean World Stroke Organization Brain and Heart global Initiative Stroke (WSO BEAT-STROKE) Evaluation for Adherence to Treatment Neurocardiology Score by category
Description: This outcome evaluates adherence to best practice recommendations within each of five pre-specified categories of the WSO BEAT-STROKE Neurocardiology Score:
- Basic assessment
- Stroke-heart syndrome
- Embolic stroke of undetermined source (ESUS) workup
- Patent foramen ovale (PFO) in young patients
- Atrial fibrillation (AF) management
Scale range: 0 (no adherence) to 10 (full adherence).
Interpretation: Higher scores indicate greater adherence to guideline-recommended care.
Calculation: Each patient's category score is calculated as the sum of points achieved within that category divided by the maximum possible points for which the patient is eligible.
Measured: 6-months
Long-term achievement of the primary outcome at 12 months.
Long-term difference between baseline and 12-month mean World Stroke Organization Brain and Heart global Initiative Stroke (WSO BEAT-STROKE) Evaluation for Adherence to Treatment Neurocardiology Score
Description: This outcome assesses the long-term change in adherence to guideline-recommended care, measured using the WSO BEAT-STROKE Neurocardiology Score. The score incorporates 8 weighted categories (e.g., initial workup, stroke-heart syndrome, ESUS workup, PFO, and AF management).
Scale range: 0 (no adherence) to 10 (full adherence).
Interpretation: Higher scores indicate greater adherence to best practice recommendations.
Calculation: Each patient's score is calculated as the sum of points achieved divided by the total possible points for which the patient is eligible, as not all patients qualify for ESUS, PFO, or AF items.
Time Frame: 12 months
Measured: 12-months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Sep 2024
- Study startMar 2027 (estimated)
- Primary completionMar 2028 (estimated)
- Study completionDec 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for 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
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 2,400 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Luciano A. Sposato
- Sponsor type
- University, hospital or other
- Collaborators
- W.L.Gore & Associates, Medtronic
- Responsible party
- Sponsor-investigator, Luciano A. Sposato, London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06606054
- Sponsor's protocol ID
- 14852
- Acronym
- BEAT STROKE
- Status last verified
- Sep 2026
- First submitted
- 18 Sep 2024
- Last updated
- 18 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: Upon reasonable request and after the Approval of Western University Ethics Review Board