- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00932425
Long-term Cardiac Monitoring After Cryptogenic Stroke (CMACS) (CMACS)
February 12, 2015 updated by: University of California, San Francisco
Long-term Cardiac Monitoring After Cryptogenic Stroke (CMACS): A Pilot Randomized Trial
Atrial fibrillation (AF) is a common and treatable cause of ischemic stroke, but it can be paroxysmal and asymptomatic, and therefore difficult to detect.
Patients with stroke routinely undergo 24 hours of continuous cardiac telemetry during hospitalization for stroke as a means of excluding AF.
Small studies indicate that extending the duration of monitoring with portable outpatient telemetry devices detects more cases of AF.
However, these studies are small and lack control groups, and cannot demonstrate that prolonged cardiac monitoring detects more cases of AF than routine clinical follow-up.
The investigators therefore propose a pilot study to determine the feasibility of randomizing patients to prolonged cardiac monitoring or routine clinical follow-up.
The investigators will enroll 40 consecutive adult patients seen at the University of California at San Francisco (UCSF) Neurovascular service with cryptogenic stroke or high-risk TIA (ABCD2 score 4 or greater).
Enrolled patients will be randomized in a 1:1 fashion.
Group A will be assigned to wear an ambulatory cardiac event monitor for 21 days.
Group B will be discharged home without a monitor and will serve as controls during routine clinical follow-up.
The investigators' primary outcome will be feasibility, defined as more than 80% of randomized patients completing full clinical follow-up and more than 70% of cardiac monitoring if applicable.
The investigators' secondary outcomes will be diagnoses of AF at 90 days and 1 year and diagnoses of recurrent stroke at 1 year.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
40
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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California
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San Francisco, California, United States, 94143
- University of California, San Francisco
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age > 18 years
- Seen at UCSF Medical Center for cryptogenic stroke or high-risk TIA
- Onset of stroke or TIA symptoms within the previous 60 days
Exclusion Criteria:
- Definite small-vessel etiology by history or imaging
- Source found on vascular imaging of possible culprit vessels
- Source found by echocardiography (TEE not required)
- History of atrial fibrillation
- Atrial fibrillation on admission ECG
- Atrial fibrillation detected by inpatient cardiac telemetry (at least 24 hours required)
- Obvious culpable systemic illness such as endocarditis
- Patient unable to provide written, informed consent
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: DIAGNOSTIC
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Outpatient cardiac monitoring
Patients will be assigned to wear a portable outpatient cardiac telemetry device for 21 days
|
Patients will be assigned to wear the telemetry device for 21 days
|
No Intervention: Control
Patients will be discharged home with standard clinical follow-up
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Completion of Clinical Follow-up as a Measure of Feasibility
Time Frame: 1 year
|
Feasibility was defined as 90% or more of randomized patients completing full clinical follow-up and 70% or more completion of assigned cardiac monitoring if applicable
|
1 year
|
Completion of Assigned Monitoring as a Measure of Feasibility
Time Frame: 21 days
|
Feasibility criteria included more than 70% completion of cardiac monitoring if applicable.
Patients in the Monitoring arm were assigned to wear a Cardionet mobile cardiac outpatient telemetry monitor for 21 days.
Outpatient monitoring began 22 days (+/- 12 days) after symptom onset.
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21 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Diagnosis of Atrial Fibrillation
Time Frame: 90 days
|
90 days
|
|
Diagnosis of Atrial Fibrillation
Time Frame: 1 year
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1 year
|
|
Recurrent Stroke or TIA
Time Frame: 1 year
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Patients and their primary physicians or neurologists were contacted at 3 months and 1 year after discharge and reported clinical diagnoses of recurrent stroke or TIA using validated questionnaires.
Reported events were verified by review of relevant medical records.
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1 year
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
September 1, 2009
Primary Completion (Actual)
May 1, 2011
Study Completion (Actual)
May 1, 2011
Study Registration Dates
First Submitted
July 1, 2009
First Submitted That Met QC Criteria
July 2, 2009
First Posted (Estimate)
July 3, 2009
Study Record Updates
Last Update Posted (Estimate)
February 27, 2015
Last Update Submitted That Met QC Criteria
February 12, 2015
Last Verified
February 1, 2015
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CMACS
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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