New breakthrough research is being carried out to provide critical insight into stroke prevention and treatment following a ‘mini stroke’.
The PREDICT-EV study will test new biomarkers in patients after their first ‘mini stroke’, otherwise known as a Transient Ischaemic Attack (TIA).
Patients will be screened for microscopic vesicles in the blood, which if present in large numbers, can render certain patients at significant risk of blood clotting.
Annually, 46,000 British people have their first ‘mini-stroke’, which is a temporary block of the oxygen-rich blood supply to the brain.
Patients present the usual stroke signs, recognised by the FAST campaign, which resolve very quickly and can often go unnoticed.
Despite the best current treatment, individuals are four times more likely to have a major stroke in the following 12 months, because of their increased risk of forming new blood clots that can cause permanent brain damage.
Currently, there is no robust way of predicting which patients are more at risk.
The research, from Cardiff Metropolitan University in collaboration with the Cwm Taf Morgannwg University Health Board (CTMUHB), has been supported with £250,000 from the Stroke Association to allow it to expand recruitment and follow patients over time.
“Clinical clotting time assessment is not carried out routinely after a ‘mini-stroke’ but is captured in a small percentage of patients,” said Professor of Cardiovascular Metabolism, Philip James, at Cardiff Metropolitan University, who leads the PREDICT-EV team.
“We wish to take advantage of the fact that 85 per cent of Welsh patient records have been monitored over 20 years, providing a powerful resource to enable us to retrospectively determine if clotting time at the time of a ‘mini stroke’ was associated with a future stroke in a large population.
“We have investigated how blood clots after a ‘mini-stroke’ to explain increased stroke risk and have found that microscopic vesicles made by the cells lining our blood vessels could be the cause.
“State-of-the-art laboratory tests have been developed to measure vesicles in blood and we believe they could be used, together with clinical clotting tests, as a new marker to predict stroke in at-risk patients.”
Katie Chappelle, associate director Wales at the Stroke Association said: “Having a TIA is a major sign that having a full-blown stroke could be on the way. We need to know more about the link between TIA and stroke risk, so that we can better predict and have strategies to prevent stroke in people who have had a TIA.
“We are delighted to be able to award Cardiff Metropolitan University funding for this study, which could teach us crucial things about TIA and stroke and help us to save lives.
“Preventing a stroke is a key priority for stroke research and care. We are therefore pleased to enable researchers like Professor Philip James to find new ways to improve stroke prevention and inform treatment.”
Professor John Geen, assistant director for research and development at CTMUHB, said: “We are very excited to be the clinical partner and provider of the delivery support for this high quality research study.
“We have worked closely with Cardiff Metropolitan University to design and progress the study. Our team members highlighted the importance of the early stage pilot study that provided early data and an invaluable insight that has helped inform and evolve the pathways required to optimise recruitment, patient follow-up and design of the planned larger study, supported by the Stroke Association funding.
“The study is an excellent example of academia, the NHS and third sector partners, working collaboratively, sharing resources and common strategic objectives to undertake research that has the potential to have an impact on patient care and benefit the population of Wales and beyond.”
