Stroke Trials Network of Columbia and Cornell

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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 6,700 strokes in 2016. 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 August, 2017 was 375 subjects. Historically, over the last 10 years, Columbia and Cornell have been involved in 44 human stroke studies, including 29 stroke clinical trials, 10 stroke biomarker studies, and 5 stroke outcomes studies. 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. The STNCC has also provided leadership at the national level in the first 5 years of StrokeNet. Contact PI Randolph Marshall served on the NCC Executive Committee for the first 3 years, as Co-Chair of the Education and Training Core for all 5 years, and on the Recovery and Rehabilitation Working Group over the last year. He has been invited to continue the latter two roles in the upcoming renewal period. Co-I Ronald Lazar, now at UAB, served on the Recovery and Rehab WG for three years, and Co-PI E Sander Connolly has served on the Neurosurgery advisory group. In terms of innovation and clinical trial development, our RCC has the distinction of submitting and obtaining funding for two of the new StrokeNet studies. 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 5 trainees producing 22 abstracts and 21 manuscripts within 1 year of Fellowship, and 4 so far have Assistant Professor positions at major academic institutions (all StrokeNet sites). Two are applying for K-awards.