The Virtual International Stroke Trials Archive (VISTA): results and impact on future stroke trials and management of stroke patients

Weimar, C., Ali, M., Lees, K.R., Bluhmki, E., Donnan, G. A. and Diener, H. C. (2010) The Virtual International Stroke Trials Archive (VISTA): results and impact on future stroke trials and management of stroke patients. International Journal of Stroke, 5(2), pp. 103-109.

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Abstract

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

Item Type:Articles
Keywords:ACUTE ISCHEMIC-STROKE aged BLOOD blood pressure BLOOD-PRESSURE CARE clinical trials database DECOMPRESSIVE SURGERY DESIGN DISEASE EVENTS IMPACT IMPLEMENTATION INTRACEREBRAL HEMORRHAGE INTRAVENOUS ANCROD LEVEL MALIGNANT INFARCTION MANAGEMENT MIDDLE CEREBRAL-ARTERY MODEL MORTALITY OF-HEALTH STROKE outcome OUTCOMES predictors prognosis RANDOMIZED CONTROLLED-TRIAL stroke TISSUE-PLASMINOGEN ACTIVATOR Treatment TRIAL
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lees, Professor Kennedy and Ali, Dr Myzoon
Authors: Weimar, C., Ali, M., Lees, K.R., Bluhmki, E., Donnan, G. A., and Diener, H. C.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences
Journal Name:International Journal of Stroke
ISSN:1747-4930

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