Stroke

BRAINS: British Repository of DNA in Stroke: towards the identification of new drug targets

Principle Investigator:
Professor Pankaj Sharma

There are currently few treatments for stroke, either antiplatelets or anticoagulants. The BRAINS study is trying to identify which genes are responsible for stroke to enable development of targeted drugs and health campaigns for those who may be genetically at risk.

Patients who are over 18, Caucasian or South Asian who have had a haemorrhagic or ischaemic stroke defined on CT or MRI.

Control patients are also needed for this study who have not had a stroke so non blood relatives of the stroke patients are also eligible to join the study.

BEAST: Biorepository to Establish the Aetiology of Sinovenous Thrombosis

Principle Investigator:
Professor Pankaj Sharma

To establish a DNA biorepository of cerebral venous thrombosis (CVT) patients of adult age. CVT accounts for only 1% of strokes.

To join this study patients must be over 18 and have had a CVT determined using CT, MRI, CTA, MRA or angiogram.

DNA Lacunar Genetic risk factors for cerebral small vessel disease

Principle Investigator:
Dr Brendan Affley

Cerebral small vessel disease (SVD) is a serious health problem responsible for about a fifth of all strokes (lacunar stroke) worldwide and is the major cause of vascular cognitive impairment and dementia, and is also an important pathology underlying intracerebral haemorrhage. The pathogenesis of SVD is largely unknown, and this knowledge gap is a major factor behind the lack of specific therapies to delay SVD progression.

This study is looking for genes causing a particular type of stroke affecting small blood vessels in the brain.

Patients who have had a lacunar stroke within the last 2 years (with an MRI within 1 year of recruitment) are eligible to join this study.

OPTIMAS: OPtimal TIMing of Anticoagulation after acute ischaemic Stroke.

Principle Investigator:
Dr Brendan Affley

Intervention: early initiation of any direct oral anticoagulant (DOAC) at a dose licensed for stroke prevention in AF, within four days (96hrs) of onset of acute ischaemic stroke

Control: standard initiation of any DOAC at a dose licensed for stroke prevention in AF, no sooner than day 7 and no later than day 14 after the onset of acute ischaemic stroke (i.e. between 144hrs and 336hrs from onset).

Participants will be randomised 1:1 to the intervention or control. The exact timing of initiating treatment within each group is at the discretion of the treating clinician.

Patients with acute ischaemic stroke and atrial fibrillation (AF) (including paroxysmal, persistent or permanent AF, or atrial flutter).

Patients are aged 18 years or over and Clinical diagnosis of acute ischaemic stroke are eligible for the trial. AF (including paroxysmal, persistent or permanent AF, or atrial flutter), confirmed by ECG, Telemetry or Other prolonged ECG monitoring technique (e.g., Holter monitor).