Comparative Effectiveness Study of Transthoracic and Transesophageal Echocardiography in Stroke
Comparative Effectiveness Study of Transthoracic and Transesophageal Echocardiography in Stroke
The Comparative Effectiveness Study of Transthoracic and Transesophageal Echocardiography in
 Stroke (CONTEST) aims at assessing the diagnostic value of transesophageal echocardiography
 (TEE) and transthoracic echocardiography (TTE) with regards to treatment consequences in
 patients with acute ischemic stroke.
For this purpose, the investigators will perform a prospective multicenter diagnostic
 comparative effectiveness study. Patients with acute stroke will be studied by both TTE and
 TEE. Patients with already defined stroke etiology and determined secondary prevention will
 be excluded from the trial. Treatment relevant diagnostic findings will be identified by a
 central endpoint adjudication committee. In order to demonstrate a hypothesized 2% absolute
 increase in the number of treatment relevant diagnostic findings by TEE as compared to TTE,
 880 stroke patients will be enrolled in six German stroke centers. CONTEST will allow
 answering the question whether and for which group of stroke patients TEE is indicated in
 addition to TTE. By this, the study will provide evidence to guide justified recommendations
 for echocardiography in acute stroke patients.
Inclusion Criteria:

 -  acute ischemic stroke or transitory ischemic attack (TIA)

 -  age ≥18 years

 -  informed consent

 Exclusion Criteria:

 -  Patients with already defined stroke etiology and determined secondary prevention
 treatment strategy prior to echocardiography (e.g. atrial fibrillation, carotid artery
 stenosis, cervical artery dissection)