Comparative Effectiveness Study of Transthoracic and Transesophageal Echocardiography in Stroke

Study Overview
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Brief Summary
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The Comparative Effectiveness Study of Transthoracic and Transesophageal Echocardiography in Stroke (CONTEST) aims at assessing the diagnostic value of transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) with regards to treatment consequences in patients with acute ischemic stroke.

Detailed Description
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For this purpose, the investigators will perform a prospective multicenter diagnostic comparative effectiveness study. Patients with acute stroke will be studied by both TTE and TEE. Patients with already defined stroke etiology and determined secondary prevention will be excluded from the trial. Treatment relevant diagnostic findings will be identified by a central endpoint adjudication committee. In order to demonstrate a hypothesized 2% absolute increase in the number of treatment relevant diagnostic findings by TEE as compared to TTE, 880 stroke patients will be enrolled in six German stroke centers. CONTEST will allow answering the question whether and for which group of stroke patients TEE is indicated in addition to TTE. By this, the study will provide evidence to guide justified recommendations for echocardiography in acute stroke patients.

Official Title
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Comparative Effectiveness Study of Transthoracic and Transesophageal Echocardiography in Stroke

Conditions
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Stroke, Acute

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: acute ischemic stroke or transitory ischemic attack (TIA) age ≥18 years informed consent Exclusion Criteria: Patients with already defined stroke etiology and determined secondary prevention treatment strategy prior to echocardiography (e.g. atrial fibrillation, carotid artery stenosis, cervical artery dissection)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Diagnostic Findings That Lead to a Change in Acute Treatment or Treatment for Secondary Prevention | Treatment relevant diagnostic findings identified by a central endpoint adjudication committee comprising both cardiologists and neurologists. | Inpatient treatment on a stroke unit usually <7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Patients With Change of Assessment of Stroke Etiology After TEE | Number of patients with change in the assessment of stroke etiology (cardioembolism, large artery atherosclerosis, small vessel disease, other determined etiology, unknown etiology) after performing TEE | Inpatient treatment on a stroke unit usually <7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stroke, echocardiography