Stroke Trials Network of Columbia and Cornell

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NINDS Stroke Trials Network Regional Coordinating Center (RCC) application RS Marshall, ES Connolly, D Leifer, M Fink, P Stieg, Co-PIs SUMMARY The Stroke Trials Network of Columbia and Cornell (STNCC) has a primary goal of maximizing stroke clinical trial enrollment for New York. Columbia and Cornell, situated on the west and east side of Manhattan, respectively, will form the two hubs, supported by an Acute Treatment Sub-network of 3 hospitals in Brooklyn and New Jersey, a Recovery Sub-network comprising 2 affiliated academic Rehabilitation Centers in Westchester County and New Jersey, and 4 Academic Medical Centers in Brooklyn and in Western New York. Our hubs and satellites treated just over 8,700 strokes in 2022. More importantly, our RCC has an extensive leadership record in stroke clinical trials, and have the distinction of being the leading enroller in Stroke clinical trials over the first 5 years of StrokeNet; Our total enrollment as of November 2022 was 775 subjects, including the trials rolling into StrokeNet from prior years. The demographics in our network overall are very favorable for enrolling underserved minority populations: Columbia has 40% Hispanic and 25% African American; Cornell 15% Asian, and St. Joseph’s 24% African American, 30% Hispanic, 12% other. Part of our success is due to the highly organized and interactive infrastructure. We hold monthly videoconferences attended by PIs and coordinators from all RCC hubs and satellite sites, and standardized daily stroke admission screening across the RCC. These data as well as trial enrollments are reviewed at the monthly videoconference calls. In addition to our contributions in clinical trial enrollment, the STNCC has been extremely active in leadership roles in the first 10 years. Dr. Randolph Marshall and Dr. Dana Leifer have been regular members of the StrokeNet Steering Committee for 10 years. Dr. Marshall served on the NCC Executive Committee for years 1 and 2. He is also Chair of the Education and Training Core, having served as Co-Chair for 7 years prior. Dr. Ron Lazar (now at UAB), served on the Recovery Working Group in years 1 and 2, and was succeeded by Dr. Marshall, later joined by Co-I Dr. Tomoko Kitago in 2021. Dr. Connolly served on the neurosurgical advisory group. We have had 100% participation at all national meetings and conference calls. In terms of innovation and clinical trial development, our RCC has the distinction of submitting and obtaining funding for two of the StrokeNet RCTs. STNCC Co-Is Mitchell Elkind and Hooman Kamel are Co-PI’s on the ARCADIA trial, a multi-center Phase 3 RCT to determine whether apixaban is superior to standard therapy for patients with cryptogenic stroke and “atrial cardiopathy.” Randolph Marshall, Sander Connolly, and Ronald Lazar are Co-PI’s on the CREST-H study, an ancillary study to the CREST-2 trial, testing the hypothesis that revascularization can improve cognition in as subset of patients with high grade asymptomatic carotid stenosis who have cerebral hemodynamic failure. Finally, our StrokeNet trainee program has been highly successful, with 11 trainees producing 22 abstracts and 58 manuscripts within 1 year of Fellowship, and 10 have Assistant Professor positions at major academic institutions (all StrokeNet sites). Two have had for K-awards and 2 have R01s.