<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03244215</url>
  </required_header>
  <id_info>
    <org_study_id>15304/15</org_study_id>
    <nct_id>NCT03244215</nct_id>
  </id_info>
  <brief_title>The Recurrence Study</brief_title>
  <official_title>Evaluation Of Risk Of Recurrence Of Stroke And Vascular Events In Patients Presenting With Acute Stroke And Tia To Hamad General Hospital</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Hamad Medical Corporation</agency>
      <agency_class>Industry</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Hamad Medical Corporation</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The primarily goal of the research is to better understand progression of disease in patients&#xD;
      who present with an acute stroke to the Hamad General Hospital (HGH) stroke and Transient&#xD;
      Ischemic Attack (TIA) clinic. The investigators are specifically interested in patients who&#xD;
      have diabetes and have a stroke.&#xD;
&#xD;
      The patients enrolled into the research will have detailed clinical evaluation and their&#xD;
      imaging studies (MRI and Doppler) will be reviewed. After informed consent, subjects will be&#xD;
      examined in the stroke Ward /TIA clinic upon recruitment, and later at less than 48 hours of&#xD;
      recruitment (blood extraction and urine samples) and for follow up visits at 1 month+/-7 days&#xD;
      (clinical evaluation and to extract blood and urine samples), at 3 months (telephonic&#xD;
      conversation only) and at 1 year (clinical and repeat MRI brain).&#xD;
&#xD;
      During the initial visit at the ward the investigators will collect serum and plasma for&#xD;
      proteomic and metabolomic studies. These will be repeated at less than 48 hours and at 1&#xD;
      month+/-7 days. Investigators will test the effects of risk factors such as diabetes/stroke&#xD;
      on the endothelial procoagulant and inflammatory state at onset and evaluate if best medical&#xD;
      control leads to improvement in such markers.The repeated studies will determine if better&#xD;
      management and presence of certain blood biomarkers can predict or translate to slower&#xD;
      progression of disease and correlate it with clinical status.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Patient admitted to the stroke service with acute stroke and TIAs will be eligible for the&#xD;
      study. The study will enroll patients at Hamad General Hospital in the setting of the Stroke&#xD;
      Ward.&#xD;
&#xD;
      The investigators anticipate approximately 300 patients to be enrolled based on the number of&#xD;
      strokes that are admitted to the HGH stroke service every year.&#xD;
&#xD;
      The research primarily involves the evaluation of best medical therapy, and the incidence of&#xD;
      biomarkers in the recurrence and progression of the disease in a high-risk cohort of stroke&#xD;
      and TIA patients.&#xD;
&#xD;
      After obtaining informed consent the subjects medical information such as medical history&#xD;
      will be collected in the case record forms. subjects MRI studies ( performed as standard of&#xD;
      care) will be analyzed with a special software to determine the extent and volume of the most&#xD;
      recent infarction. The degree of previous white matter damage and any incidental previous&#xD;
      strokes will be recorded. MRI brain is a routine imaging technique in the care of stroke&#xD;
      patients. Corneal confocal microscopy (CCM) imaging will be ordered for subjects whose&#xD;
      standard of care attending physicians havent ordered for them. Some Stroke patients at HGH&#xD;
      are ordered CCM if considered necessary by their physician. For the purpose of the study, the&#xD;
      investigators would like to order CCM for all the subjects. CCM can be perfomed at anytime&#xD;
      within the first month of recruitment into the study so the investigators will have it&#xD;
      scheduled as it is convenient to the subjects within the month. The investigators hypothesize&#xD;
      that corneal nerve loss may be driven by the same common vascular risk factors which may lead&#xD;
      to stroke and thereby provide a surrogate for cerebral neuronal loss and hence pre-stroke&#xD;
      'neuronal reserve'. Hence CCM may allow us to identify the extent of risk factor burden.&#xD;
      Furthermore, the quantification of corneal nerves may allow the identification of those with&#xD;
      a lower pre-stroke neuronal reserve, and hence may suffer worse neurological outcomes&#xD;
      following a stroke.&#xD;
&#xD;
      The subjects will be offered the best medical treatment for stroke, risk factors will be&#xD;
      assessed by a team of stroke neurologists and nurse specialists. There will be regular&#xD;
      follow-up visits at 1 month+/- 7 days, 3 months ( telephonic follow up only) and 1 year&#xD;
      (clinical and repeat MRI brain).&#xD;
&#xD;
      After consent, serum and plasma will be obtained at onset of participation: Sample A (at&#xD;
      onset), Sample B: within less than 48 hours, and Sample C:at 30 day +/- 1 week follow up&#xD;
      visit. The blood samples will assist the team to study pro-coagulant and inflammatory&#xD;
      markers. The team will require 10 mL ( 3 vials, 2 of which will have 4 mL of blood and the&#xD;
      3rd will have 2 mL) of blood on the aforementioned three days.&#xD;
&#xD;
      The blood , plasma and urine samples will undergo testing at the Neuroscience lab at iTRI,&#xD;
      HMC, Qatar. A comparison between the different circulating biomarkers, proteins, DNA and&#xD;
      metabolites might provide useful information on correlation between diabetes ( and other risk&#xD;
      factors) and stroke. A variety of techniques are to be used including the following&#xD;
&#xD;
        1. Metabolites (metabolomics) High performance liquid chromatography (HPLC) and Liquid&#xD;
           chromatography mass spectroscopy (LC/MS/MS) for detection of branching amino acids,&#xD;
           glycine, aromatic amino acids and neurotransmitters.&#xD;
&#xD;
           Molecular biology techniques for detection of cytokines and interleukins Measurement of&#xD;
           microparticles and their content in human serum via flow cytometry ELISA for detection&#xD;
           of reactive oxygen species SDS-PAGE for detection of cysteine proteases and inflammatory&#xD;
           response proteins vWF testing to be done in Hamad General Hospital laboratory&#xD;
&#xD;
        2. Proteomics In the proposed study, th einvestigators will use a proteomics based approach&#xD;
           to perform a global proteomic profiling using the plasma from patients reportedly&#xD;
           suffering from ischemic stroke and are at the same time diabetic. The proteomic&#xD;
           profiling could lead to the identification of set of novel proteins that can be used as&#xD;
           potential markers involved in the ischemic stroke development in patients with diabetic&#xD;
           condition. By using a gel-based proteomics approach, the plasma proteins will be&#xD;
           subjected to pre-fractionation by SDS-PAGE analysis followed by in-gel tryptic digestion&#xD;
           and the purified peptides will be analyzed by Liquid Chromatography coupled to tandem&#xD;
           Mass Spectrometry. The sequenced peptides will be searched against the available&#xD;
           database to obtain protein identifications.&#xD;
&#xD;
      Samples required: Serum, plasma and urine samples. Plasma can be retrieved from whole blood&#xD;
      in EDTA sample bottles after centrifugation. Serum can be retrieved from whole blood in plain&#xD;
      sample bottles after centrifugation. Urine can be collected in plain sample bacti bottles.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date type="Actual">February 17, 2016</start_date>
  <completion_date type="Anticipated">May 17, 2018</completion_date>
  <primary_completion_date type="Anticipated">February 17, 2018</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Non-Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Other</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Circulating Biomarkers</measure>
    <time_frame>Blood samples will be assessed at baseline</time_frame>
    <description>The primary outcome will be to assess blood inflammatory biomarker levels in both the study group as well as the controls at baseline</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Circulating biomarkers</measure>
    <time_frame>Blood samples will be extracted at 48 hours</time_frame>
    <description>To assess blood inflammatory biomarker levels in the study group at less than 48 hours</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Circulating biomarkers</measure>
    <time_frame>Blood samples will be extracted at 1 month+/- 7 days</time_frame>
    <description>To assess blood inflammatory biomarker levels in the study group at less than 1 month+/- 7 days</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Progression of disease</measure>
    <time_frame>1 year</time_frame>
    <description>We will measure the plaque volume in the stroke patients by conducting an MRI scan at admission to the hospital and later repeating it at year 1. We will also utilize corneal confocal imaging as a surrogate procedure to assess the progression of stroke and other vascular events.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">300</enrollment>
  <condition>Acute Stroke</condition>
  <condition>Transient Ischemic Attack</condition>
  <arm_group>
    <arm_group_label>The study group</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>The intervention to be evaluated is the patient response and compliance to best medical treatment and prevention of recognized stroke risk factors and the recurrence of stroke and TIA in the study group and its relation to the incidence of blood biomarkers.&#xD;
The Nurse practitioners at the stroke ward will withdraw blood and collect urine samples from all the subjects. All the subjects from the study group will have 2 follow up visits (1 month and at 1 year) at HGH and one telephonic follow up at 3 months. The blood samples will be used to monitor blood inflammatory biomarker levels. At the beginning of the study, all subjects will have an MRI scan to assess plaque volume (this MRI scan will be ordered as part of the standard of care as per the policies applied to all stroke patients). MRI scans will be repeated at one year to assess any progression or regression in the plaque volume of the subjects.&#xD;
No drugs will be administered to the patients for the purpose of our study.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Control</arm_group_label>
    <arm_group_type>Other</arm_group_type>
    <description>The control group will have blood work done to assess their blood inflammatory biomarkers but not the corneal confocal imaging.</description>
  </arm_group>
  <intervention>
    <intervention_type>Diagnostic Test</intervention_type>
    <intervention_name>Corneal Confocal Imaging</intervention_name>
    <description>Retinal imaging will be ordered for all subjects in the study group. Corneal</description>
    <arm_group_label>The study group</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Diagnostic Test</intervention_type>
    <intervention_name>Magnetic resonance Imaging</intervention_name>
    <description>MRI will be ordered for all study subjects at the completion of their participation at year 1. The MRI will assess the the progression or regression of the cerebrovascular health of the study subjects.</description>
    <arm_group_label>The study group</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Blood sample</intervention_name>
    <description>Blood samples will be obtained to evaluate the levels of blood inflammatory biomarkers in both the subjects and control group.</description>
    <arm_group_label>Control</arm_group_label>
    <arm_group_label>The study group</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Subjects 18 years and older&#xD;
&#xD;
          -  Subjects willing to give consent and agree to regular follow up visits;&#xD;
&#xD;
          -  Male/Female patients of all nationalities admitted to HGH or seen in the Stroke Ward/&#xD;
             TIA clinics with a confirmed diagnosis of acute stroke and TIA, confirmed on the&#xD;
             initial standard of care ordered MRI imaging.&#xD;
&#xD;
          -  Stroke onset is less than 48 hours.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Pregnant women or individuals with cognitive disabilities.&#xD;
&#xD;
          -  individuals with onset &gt; 48 hours.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Naveed Akhtar, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Hamad Medical Corporation</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Ashfaq Shuaib, FRCPC</last_name>
    <role>Study Chair</role>
    <affiliation>University of Alberta</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Naveed Akhtar, MD</last_name>
    <phone>+974 44392773</phone>
    <phone_ext>94124</phone_ext>
    <email>nakhtar@hamad.qa</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Rabia Khan, BSc</last_name>
    <phone>+97440253348</phone>
    <email>rkhan5@hamad.qa</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>The Neuroscience Institute, Hamad Medical Corporation</name>
      <address>
        <city>Doha</city>
        <zip>3500</zip>
        <country>Qatar</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Naveed Akhtar, MD</last_name>
      <email>nakhtar@hamad.qa</email>
    </contact>
    <contact_backup>
      <last_name>Deborah Morgan, BSc</last_name>
      <email>dmorgan@hamad.qa</email>
    </contact_backup>
  </location>
  <location_countries>
    <country>Qatar</country>
  </location_countries>
  <verification_date>August 2017</verification_date>
  <study_first_submitted>June 4, 2017</study_first_submitted>
  <study_first_submitted_qc>August 8, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">August 9, 2017</study_first_posted>
  <last_update_submitted>August 8, 2017</last_update_submitted>
  <last_update_submitted_qc>August 8, 2017</last_update_submitted_qc>
  <last_update_posted type="Actual">August 9, 2017</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Hamad Medical Corporation</investigator_affiliation>
    <investigator_full_name>Dr.Naveed Akhtar</investigator_full_name>
    <investigator_title>Consultant Neurologist</investigator_title>
  </responsible_party>
  <keyword>Recurrence of stroke</keyword>
  <keyword>Corneal Confocal Microscopy</keyword>
  <keyword>High performance liquid chromatography,</keyword>
  <keyword>Inflammatory biomarkers</keyword>
  <keyword>modified Rankin scale ( mRS)</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Stroke</mesh_term>
    <mesh_term>Ischemic Attack, Transient</mesh_term>
    <mesh_term>Recurrence</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
    <ipd_description>We do not plan to share any IPD with other investigators.</ipd_description>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03244215
org study id: 15304/15
nct id: NCT03244215
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The primarily goal of the research is to better understand progression of disease in patients
      who present with an acute stroke to the Hamad General Hospital (HGH) stroke and Transient
      Ischemic Attack (TIA) clinic. The investigators are specifically interested in patients who
      have diabetes and have a stroke.

      The patients enrolled into the research will have detailed clinical evaluation and their
      imaging studies (MRI and Doppler) will be reviewed. After informed consent, subjects will be
      examined in the stroke Ward /TIA clinic upon recruitment, and later at less than 48 hours of
      recruitment (blood extraction and urine samples) and for follow up visits at 1 month+/-7 days
      (clinical evaluation and to extract blood and urine samples), at 3 months (telephonic
      conversation only) and at 1 year (clinical and repeat MRI brain).

      During the initial visit at the ward the investigators will collect serum and plasma for
      proteomic and metabolomic studies. These will be repeated at less than 48 hours and at 1
      month+/-7 days. Investigators will test the effects of risk factors such as diabetes/stroke
      on the endothelial procoagulant and inflammatory state at onset and evaluate if best medical
      control leads to improvement in such markers.The repeated studies will determine if better
      management and presence of certain blood biomarkers can predict or translate to slower
      progression of disease and correlate it with clinical status.
Patient admitted to the stroke service with acute stroke and TIAs will be eligible for the
      study. The study will enroll patients at Hamad General Hospital in the setting of the Stroke
      Ward.

      The investigators anticipate approximately 300 patients to be enrolled based on the number of
      strokes that are admitted to the HGH stroke service every year.

      The research primarily involves the evaluation of best medical therapy, and the incidence of
      biomarkers in the recurrence and progression of the disease in a high-risk cohort of stroke
      and TIA patients.

      After obtaining informed consent the subjects medical information such as medical history
      will be collected in the case record forms. subjects MRI studies ( performed as standard of
      care) will be analyzed with a special software to determine the extent and volume of the most
      recent infarction. The degree of previous white matter damage and any incidental previous
      strokes will be recorded. MRI brain is a routine imaging technique in the care of stroke
      patients. Corneal confocal microscopy (CCM) imaging will be ordered for subjects whose
      standard of care attending physicians havent ordered for them. Some Stroke patients at HGH
      are ordered CCM if considered necessary by their physician. For the purpose of the study, the
      investigators would like to order CCM for all the subjects. CCM can be perfomed at anytime
      within the first month of recruitment into the study so the investigators will have it
      scheduled as it is convenient to the subjects within the month. The investigators hypothesize
      that corneal nerve loss may be driven by the same common vascular risk factors which may lead
      to stroke and thereby provide a surrogate for cerebral neuronal loss and hence pre-stroke
      'neuronal reserve'. Hence CCM may allow us to identify the extent of risk factor burden.
      Furthermore, the quantification of corneal nerves may allow the identification of those with
      a lower pre-stroke neuronal reserve, and hence may suffer worse neurological outcomes
      following a stroke.

      The subjects will be offered the best medical treatment for stroke, risk factors will be
      assessed by a team of stroke neurologists and nurse specialists. There will be regular
      follow-up visits at 1 month+/- 7 days, 3 months ( telephonic follow up only) and 1 year
      (clinical and repeat MRI brain).

      After consent, serum and plasma will be obtained at onset of participation: Sample A (at
      onset), Sample B: within less than 48 hours, and Sample C:at 30 day +/- 1 week follow up
      visit. The blood samples will assist the team to study pro-coagulant and inflammatory
      markers. The team will require 10 mL ( 3 vials, 2 of which will have 4 mL of blood and the
      3rd will have 2 mL) of blood on the aforementioned three days.

      The blood , plasma and urine samples will undergo testing at the Neuroscience lab at iTRI,
      HMC, Qatar. A comparison between the different circulating biomarkers, proteins, DNA and
      metabolites might provide useful information on correlation between diabetes ( and other risk
      factors) and stroke. A variety of techniques are to be used including the following

        1. Metabolites (metabolomics) High performance liquid chromatography (HPLC) and Liquid
           chromatography mass spectroscopy (LC/MS/MS) for detection of branching amino acids,
           glycine, aromatic amino acids and neurotransmitters.

           Molecular biology techniques for detection of cytokines and interleukins Measurement of
           microparticles and their content in human serum via flow cytometry ELISA for detection
           of reactive oxygen species SDS-PAGE for detection of cysteine proteases and inflammatory
           response proteins vWF testing to be done in Hamad General Hospital laboratory

        2. Proteomics In the proposed study, th einvestigators will use a proteomics based approach
           to perform a global proteomic profiling using the plasma from patients reportedly
           suffering from ischemic stroke and are at the same time diabetic. The proteomic
           profiling could lead to the identification of set of novel proteins that can be used as
           potential markers involved in the ischemic stroke development in patients with diabetic
           condition. By using a gel-based proteomics approach, the plasma proteins will be
           subjected to pre-fractionation by SDS-PAGE analysis followed by in-gel tryptic digestion
           and the purified peptides will be analyzed by Liquid Chromatography coupled to tandem
           Mass Spectrometry. The sequenced peptides will be searched against the available
           database to obtain protein identifications.

      Samples required: Serum, plasma and urine samples. Plasma can be retrieved from whole blood
      in EDTA sample bottles after centrifugation. Serum can be retrieved from whole blood in plain
      sample bottles after centrifugation. Urine can be collected in plain sample bacti bottles.
allocation: Non-Randomized
intervention model: Parallel Assignment
primary purpose: Other
masking: None (Open Label)
measure: Circulating Biomarkers
time frame: Blood samples will be assessed at baseline
description: The primary outcome will be to assess blood inflammatory biomarker levels in both the study group as well as the controls at baseline
measure: Circulating biomarkers
time frame: Blood samples will be extracted at 48 hours
description: To assess blood inflammatory biomarker levels in the study group at less than 48 hours
measure: Circulating biomarkers
time frame: Blood samples will be extracted at 1 month+/- 7 days
description: To assess blood inflammatory biomarker levels in the study group at less than 1 month+/- 7 days
measure: Progression of disease
time frame: 1 year
description: We will measure the plaque volume in the stroke patients by conducting an MRI scan at admission to the hospital and later repeating it at year 1. We will also utilize corneal confocal imaging as a surrogate procedure to assess the progression of stroke and other vascular events.
arm group label: The study group
arm group type: Experimental
description: The intervention to be evaluated is the patient response and compliance to best medical treatment and prevention of recognized stroke risk factors and the recurrence of stroke and TIA in the study group and its relation to the incidence of blood biomarkers.
The Nurse practitioners at the stroke ward will withdraw blood and collect urine samples from all the subjects. All the subjects from the study group will have 2 follow up visits (1 month and at 1 year) at HGH and one telephonic follow up at 3 months. The blood samples will be used to monitor blood inflammatory biomarker levels. At the beginning of the study, all subjects will have an MRI scan to assess plaque volume (this MRI scan will be ordered as part of the standard of care as per the policies applied to all stroke patients). MRI scans will be repeated at one year to assess any progression or regression in the plaque volume of the subjects.
No drugs will be administered to the patients for the purpose of our study.
arm group label: Control
arm group type: Other
description: The control group will have blood work done to assess their blood inflammatory biomarkers but not the corneal confocal imaging.
intervention type: Diagnostic Test
intervention name: Corneal Confocal Imaging
description: Retinal imaging will be ordered for all subjects in the study group. Corneal
arm group label: The study group
intervention type: Diagnostic Test
intervention name: Magnetic resonance Imaging
description: MRI will be ordered for all study subjects at the completion of their participation at year 1. The MRI will assess the the progression or regression of the cerebrovascular health of the study subjects.
arm group label: The study group
intervention type: Other
intervention name: Blood sample
description: Blood samples will be obtained to evaluate the levels of blood inflammatory biomarkers in both the subjects and control group.
arm group label: Control
arm group label: The study group
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Naveed Akhtar, MD
role: Principal Investigator
affiliation: Hamad Medical Corporation
last name: Ashfaq Shuaib, FRCPC
role: Study Chair
affiliation: University of Alberta
last name: Naveed Akhtar, MD
phone: +974 44392773
phone ext: 94124
email: nakhtar@hamad.qa
last name: Rabia Khan, BSc
phone: +97440253348
email: rkhan5@hamad.qa
facility: 
status: Recruiting
contact: 
contact backup: 
country: Qatar
responsible party type: Principal Investigator
investigator affiliation: Hamad Medical Corporation
investigator full name: Dr.Naveed Akhtar
investigator title: Consultant Neurologist
mesh term: Stroke
mesh term: Ischemic Attack, Transient
mesh term: Recurrence
sharing ipd: No
ipd description: We do not plan to share any IPD with other investigators.