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Monday, 23 October 2017
Research

Each year in the UK around 152,000 people have a stroke – one every three-and-a-half minutes. Most of those affected are over 65 but anyone can suffer a stroke – even babies.

Dr MR Chowdhury Dr S Das Dr M Ibraheem

There are two main types of stroke: Ischaemic strokes and transient ischaemic attacks (TIAs or 'mini strokes') are caused by a clot in one of the large or small blood vessels in the brain. These account for approximately 80-85% of strokes; and Haemorrhagicstrokes where there is a bleed into the brain tissue.

Research into stroke is urgently needed to answer questions about:

  • the acute treatment of patients who have had a stroke;
  • the best way of minimising complications and restoring function;
  • rehabilitation following stroke;
  • how families can be helped to care for those who have had a stroke; and – perhaps most importantly
  • prevention of stroke / TIA and prevention of recurrence of strokes.

Taking part in any research is entirely voluntary and, although a participant may not receive any direct benefit, hopefully future patients may be helped and the incidence of strokes and TIAs reduced.

There are many forms of research but the most common are:

  • clinical trials which look at the development of new drugs or treatments, or alternative ways of using existing drugs for the prevention and treatment of strokes and TIAs;
  • observational studies which examine the way patients respond to treatments and sometimes how people who have had a stroke view and understand their condition. They may also look at how families cope and respond when looking after someone who has had a stroke; and
  • genetic studies as genetic factors are increasingly found to play a part in many conditions, most clinical studies now include this aspect.

The Stroke Team at Ipswich Hospital are currently involved in two studies – one into each type of stroke:

TARDIS Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke

”This is an 'Open Label' trial, as patients know which medications they are taking, but which of the three treatment combinations they could be given is decided by the computer at the Trial Coordinating Centre after the details of their stroke or TIA have been input. Antiplatelets are drugs which act on the body’s clotting mechanism.

The trial compares the effectiveness of giving three established antiplatelet tablets together, all of which have been used in these conditions for a long time, with the current guideline therapy of giving one or two tablets, for the first month following a stroke or TIA.
TICH 2 Tranexamic Acid in Primary Intra-Cerebral Haemorrhage

Tranexamic acid is a well established medication which can stop a bleed into the brain tissue from extending and the blood clot which forms after a bleed from breaking down too soon, which might in turn lead to further bleeding. In contrast to the 'open label' TARDIS trial, where both doctor and patient are aware of the medication being taken, TICH 2 is 'double-blinded'. In this type of trial the medical and nursing staff do not know if the patient is receiving tranexamic acid or a placebo (a dummy medication) with the 50/50 chance of being randomised to either option again being decided by computer. The treatment is over in eight hours and only the people running the trial will know who has been given what.

Both trials are conducted by the Stroke Research Unit at the University of Nottingham. This was one of the earliest units in the UK and was set up at the General Hospital in 1983. Many of the first clinical trials into stroke rehabilitation were run there.

The Stroke Association is a UK charity which works to prevent stroke, to support everyone affected by stroke (patients and carers) and to fund research and to campaign for the rights of stroke survivors of all ages. Find out more from the Stroke Association website.

If you would like more information on the research conducted at Ipswich Hospital, please contact Sue Brixey, research nurse, on 01473 702515 or 702486 or email: generic.research@ipswichhospital.nhs.uk