Risk of Recurrent CeAD After Pregnancy

NCT ID: NCT06258109

Last Updated: 2024-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-01-01

Study Completion Date

2025-07-01

Brief Summary

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Primary objective: To determine whether pregnancy increases the risk of recurrent CeAD and delayed stroke in women with prior CeAD based on long-term data.

Methods: Multicentric, observational case-control study based on pooled individual patient data from several stroke centers.

Primary endpoint: Primary composite outcome measure includes the following outcomes: (i) occurrence of recurrent CeAD, (ii) occurrence of ischemic or hemorrhagic stroke, (iii) death.

Detailed Description

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Background: Cervical artery dissection (CeAD) is a leading cause of stroke in women of childbearing age. Among the population with an initial CeAD, about 9% show a recurrence event (a range from 0 to 25% has been reported). Recurrence of CeAD can occur for several years after the initial event. CeAD has been shown to occur in association with pregnancy, and the postpartum period, yet it remains unclear whether pregnancy increases the risk of recurrence or delayed stroke. Previous studies on this subject are either based on small sample sizes or lack long-term data.

Objective: The investigators want to determine whether pregnancy increases the risk of recurrent CeAD and delayed stroke in women with prior CeAD based on long-term data.

Furthermore, it will be investigated whether the mode of delivery affects recurrence and if dissections occurred during a particular phase of a woman's reproductive process. The investigators will also investigate if women actively decided against another pregnancy due to the initial CeAD.

Methods: This study will be a multicenter, exploratory case-control study using pooled individual patient data from several stroke centers. The data will be obtained through review of medical records and patient interviews. The study will include all women with any prior CeAD who have had long-term follow-up (at least 6 months, with no upper limit), including information about pregnancy and recurrence of CeAD.

Primary endpoint is a composite outcome measure which consists of (i) occurrence of recurrent CeAD, (ii) occurrence of ischemic or hemorrhagic stroke, (iii) death. Secondary endpoints are the individual components of the primary endpoint and functional outcome assessed by the modified Ranking scale.

Statistical analysis will be used to determine the odds of the primary and secondary endpoints in women who had subsequent pregnancies compared to those who did not.

Conditions

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Cervical Artery Dissection Pregnancy Complications

Keywords

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Ischemic Stroke Hemorrhagic Stroke

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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Women with pregnancy after index CeAD

Women who became pregnant at least once after first index CeAD

No interventions assigned to this group

Women without pregnancy after index CeAD

Women who did not became pregnant after first index CeAD

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* female
* prior symptomatic cervical artery dissection (= index CeAD)
* at least one long-term follow-up visit (at least 6 months after the initial event)
* with information available on outcome events:
* recurrent dissection
* ischemic stroke
* hemorrhagic stroke
* functional outcome assessed by mRS score
* with data on pregnancy after the initial event
* at least 18 years old at the initial event

Exclusion Criteria

* Male patients
* Age \<18 years
* No long-term follow-up available or long-term follow-up \< 6 months after initial event
* No data on pregnancy after initial event available
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Basel, Switzerland

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stefan T Engelter, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Basel, Switzerland

Locations

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University of Utah

Salt Lake City, Utah, United States

Site Status RECRUITING

University of Virginia

Charlottesville, Virginia, United States

Site Status RECRUITING

Stroke Unit Sanatorio Allende

Córdoba, , Argentina

Site Status RECRUITING

Department of Neurology, Medical University of Innsbruck

Innsbruck, Tyrol, Austria

Site Status RECRUITING

Helsinki University Central Hospital

Helsinki, , Finland

Site Status RECRUITING

Charité Universitätsmedizin, Centrum für Schlaganfallforschung

Berlin, , Germany

Site Status RECRUITING

Neurologische Klinik und Poliklinik, LMU Klinikum Campus Großhadern

Munich, , Germany

Site Status RECRUITING

Hadassah-Hebrew University Medical Center

Jerusalem, , Israel

Site Status RECRUITING

Neurology Clinic, University of Brescia

Brescia, , Italy

Site Status RECRUITING

Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez

Mexico City, , Mexico

Site Status RECRUITING

University Hospital Basel, Stroke Center

Basel, , Switzerland

Site Status RECRUITING

University Hospital Zurich, Stroke Center

Zurich, , Switzerland

Site Status RECRUITING

Countries

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United States Argentina Austria Finland Germany Israel Italy Mexico Switzerland

Central Contacts

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Stefan T Engelter, MD

Role: CONTACT

Phone: +41 61 326 41 05

Email: [email protected]

Sandro K Fischer

Role: CONTACT

Phone: +41 61 328 47 84

Email: [email protected]

Facility Contacts

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Stefan T Engelter, MD

Role: primary

Sandro K Fischer

Role: backup

Other Identifiers

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PB_2016_00547; ko23Engelter2

Identifier Type: -

Identifier Source: org_study_id