TY  - JOUR
A1  - Eichner, Felizitas A.
A1  - Reis, Joschua M.
A1  - Dores, Joaquim
A1  - Pavlovic, Vladimir
A1  - Kreß, Luisa
A1  - Daneshkhah, Naeimeh
A1  - Weinhardt, Renate
A1  - Grau, Armin
A1  - Mühler, Johannes
A1  - Soda, Hassan
A1  - Schwarzbach, Christopher J.
A1  - Schuler, Michael
A1  - Häusler, Karl Georg
A1  - Heuschmann, Peter U.
T1  - Cross-sectional study on patients' understanding and views of the informed consent procedure of a secondary stroke prevention trial
JF  - European Journal of Neurology
N2  - Background and purpose
Improving understanding of study contents and procedures might enhance recruitment into studies and retention during follow-up. However, data in stroke patients on understanding of the informed consent (IC) procedure are sparse.

Methods
We conducted a cross-sectional study among ischemic stroke patients taking part in the IC procedure of an ongoing cluster-randomized secondary prevention trial. All aspects of the IC procedure were assessed in an interview using a standardized 20-item questionnaire. Responses were collected within 72 h after the IC procedure and analyzed quantitatively and qualitatively. Participants were also asked their main reasons for participation.

Results
A total of 146 stroke patients (65 ± 12 years old, 38% female) were enrolled. On average, patients recalled 66.4% (95% confidence interval = 65.2%–67.5%) of the content of the IC procedure. Most patients understood that participation was voluntary (99.3%) and that they had the right to withdraw consent (97.1%); 79.1% of the patients recalled the study duration and 56.1% the goal. Only 40.3% could clearly state a benefit of participation, and 28.8% knew their group allocation. Younger age, higher graduation, and allocation to the intervention group were associated with better understanding. Of all patients, 53% exclusively stated a personal and 22% an altruistic reason for participation.

Conclusions
Whereas understanding of patient rights was high, many patients were unable to recall other important aspects of study content and procedures. Increased attention to older and less educated patients may help to enhance understanding in this patient population. Actual recruitment and retention benefit of an improved IC procedure remains to be tested in a randomized trial.
KW  - comprehension
KW  - mixed methods
KW  - informed consent
KW  - interview
KW  - ischemic stroke
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259404
VL  - 28
IS  - 8
ER  - 
TY  - JOUR
A1  - Scheitz, Jan F.
A1  - Lim, Jess
A1  - Broersen, Leonie H. A.
A1  - Ganeshan, Ramanan
A1  - Huo, Shufan
A1  - Sperber, Pia S.
A1  - Piper, Sophie K.
A1  - Heuschmann, Peter U.
A1  - Audebert, Heinrich J.
A1  - Nolte, Christian H.
A1  - Siegerink, Bob
A1  - Endres, Matthias
A1  - Liman, Thomas G.
T1  - High‐Sensitivity Cardiac Troponin T and Recurrent Vascular Events After First Ischemic Stroke
JF  - Journal of the American Heart Association
N2  - Background
Recent evidence suggests cardiac troponin levels to be a marker of increased vascular risk. We aimed to assess whether levels of high‐sensitivity cardiac troponin T (hs‐cTnT) are associated with recurrent vascular events and death in patients with first‐ever, mild to moderate ischemic stroke.

Methods and Results
We used data from the PROSCIS‐B (Prospective Cohort With Incident Stroke Berlin) study. We computed Cox proportional hazards regression analyses to assess the association between hs‐cTnT levels upon study entry (Roche Elecsys, upper reference limit, 14 ng/L) and the primary outcome (composite of recurrent stroke, myocardial infarction, and all‐cause death). A total of 562 patients were analyzed (mean age, 67 years [SD 13]; 38.6% women; median National Institutes of Health Stroke Scale=2; hs‐cTnT above upper reference limit, 39.2%). During a mean follow‐up of 3 years, the primary outcome occurred in 89 patients (15.8%), including 40 (7.1%) recurrent strokes, 4 (0.7%) myocardial infarctions, and 51 (9.1%) events of all‐cause death. The primary outcome occurred more often in patients with hs‐cTnT above the upper reference limit (27.3% versus 10.2%; adjusted hazard ratio, 2.0; 95% CI, 1.3–3.3), with a dose‐response relationship when the highest and lowest hs‐cTnT quartiles were compared (15.2 versus 1.8 events per 100 person‐years; adjusted hazard ratio, 4.8; 95% CI, 1.9–11.8). This association remained consistent in sensitivity analyses, which included age matching and stratification for sex.

Conclusions
Hs‐cTnT is dose‐dependently associated with an increased risk of recurrent vascular events and death within 3 years after first‐ever, mild to moderate ischemic stroke. These findings support further studies of the utility of hs‐cTnT for individualized risk stratification after stroke.
KW  - epidemiology
KW  - ischemic stroke
KW  - mortality/survival
KW  - troponin
KW  - vascular disease
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239039
VL  - 10
IS  - 10
ER  -