Clinical Research Directory

Integrating Wearable Monitoring and Clinical Data for Stroke Early Warning

Stroke is a leading global cause of death and disability. In 2021 there were 11.9 million incident strokes (10.7-13.2 million) and 93.8 million prevalent stroke survivors (89.0-99.3 million) worldwide. The burden in China is particularly severe: stroke is the leading cause of disability-adjusted life years lost, at 45.9 million, and causes more than 2 million deaths each year. Recurrence is common after a first stroke, with reported recurrence rates ranging from 5.7% to 51.3%; approximately 7.7% of patients recur within 3 months and 10.4% within 12 months, and a cohort study of 500,000 Chinese adults found that 41% (95% CI 41%-42%) of stroke survivors had a recurrence at 5 years. Recurrent stroke is associated with higher mortality, greater disability and increased consumption of health care resources, making secondary prevention after stroke the core element of reducing recurrence and improving prognosis. Current stroke prevention and control systems remain largely reactive. Monitoring relies mainly on the patient's subjective perception after symptom onset, emergency response is triggered by telephone calls, and there is no mechanism for pre-symptomatic active sensing or active intervention at onset. The median onset-to-door time in China is still 180-240 minutes and reperfusion treatment rates (2.4%-7%) lag behind those of developed countries. Existing risk assessment tools such as the Framingham score are static models based on demographic characteristics; they cannot reflect the spatiotemporal evolution of physiological parameters in the 24-72 hours before onset and therefore cannot detect a 'recent high-risk state'. Digital health management is mostly one-way information push without bidirectional, agent-driven interaction, resulting in low patient adherence and warning messages that rarely translate into protective action. Wearable health-monitoring devices combined with agentic artificial intelligence offer continuous, real-time and quantifiable physiological monitoring in everyday life. However, the effectiveness, feasibility and safety of such warning and intervention systems for stroke patients, especially for secondary prevention after discharge, have not been systematically evaluated. This study therefore evaluates a stroke early-warning system based on wearable monitoring and clinical data fusion, in order to provide evidence for a digital management model for stroke prevention.

Cilostazol for Prevention of Recurrent Stroke Trial

The goal of this clinical study is to learn if adding a medicine called cilostazol to usual treatment can help prevent another stroke, a heart attack, or death in patients who had a stroke caused by a blocked blood vessel, or a "mini-stroke" (also called a TIA), in the past 6 months. To determine if cilostazol is safe and effective at lowering the chance of strokes, heart attacks and deaths, the study will compare cilostazol to a placebo, a pill that looks the same as cilostazol but has no medicine in it. Participants will: * Be assigned by chance to take either cilostazol or a placebo, along with their usual medicine. * Not know which one they are taking, and neither will the study team, which keeps the results fair. * Be followed for up to 5 years to see if they have a stroke, heart attack, or major bleeding.

Plaque Characteristics Predict Recurrent Stroke in MCA Stroke Patients

The epidemiology of TOAST classification in Asian patients seems to differ due to the higher rates of large-artery atherosclerosis. The complex pathology of atherosclerosis could lead to recurrent stroke, including shear stress on the endothelium, disturbance of the flow, occlusion at the origin of the perforating artery, and other complications (plaque inflammation, plaque hemorrhage, plaque rupture) that could lead to stroke and recurrent stroke. Therefore, The exact determination of the etiology of stroke due to atherosclerosis is the most critical factor for treatment and prognostic. On the other hand, HR-MRI could be a useful imaging modality to evaluate the characteristics of plaque in stroke patients due to atherosclerosis stenosis, which will help us find out the etiology of stroke. Previous studies have demonstrated its prognosis value in predicting recurrent stroke in the same vascular territory. The investigators hypothesize that with an appropriate evaluation, HR-MRI could help to predict recurrent stroke in the same vascular territory in patients with high-risk plaque characteristics on HR-MRI. These findings could contribute to individual treatment according to etiology. The investigators intend to conduct a study to determine the correlation between plaque characteristics and recurrent stroke in the same vascular territory in ischemic stroke patients due to middle cerebral artery stenosis.

Medical Treatment With or Without Transcatheter Patent Foramen Ovale Closure

Patent foramen ovale PFO closure has been shown to reduce the risk of stroke in patients with recurrent stroke. However, the majority of existing clinical studies in this field excluded patients over the age of 60 years. Data in older patients is limited and since the population ages and stroke remains a major cause of death and morbidity, randomized clinical trials are needed to better assess the benefit of PFO closure in this elderly population. Therefore, this study proposal sought to determine the efficacy of PFO closure for the prevention of recurrent stroke in older patients with PFO and cryptogenic stroke.