Quick treatment following minor stroke reduces risk of major stroke by 80 per cent

October 10, 2007

Treating patients immediately after a minor stroke reduces the early risk of a major stroke by 80 per cent, Oxford research has found.

Two complementary papers by Oxford teams published at the same time in The Lancet and Lancet Neurology investigated both the effects of faster treatment, and what kind of treatment was best.

In the week after a TIA (transient ischaemic attack) or minor stroke, a person has a one in ten chance of a major stroke. The EXPRESS study, led by Professor Peter Rothwell in the Department of Clinical Neurology, compared urgent treatment of TIA and minor stroke using a combination of drugs (aspirin, clopidogrel, blood pressure lowering drugs and cholesterol lowering drugs) with standard treatment, in all patients with TIA or stroke coming to medical attention in a population of 100,000 people in Oxfordshire. The study showed that urgent treatment reduced the early risk of major stroke by 80 per cent.

‘Eighty per cent reductions in risk are very rare in modern medicine,’ says Professor Rothwell. ‘We normally get excited about 10–15 per cent.’

Current lack of provision in the UK, with a 14-day average waiting list at TIA and minor stroke clinics, means that thousands of patients per year have major strokes before they are seen and treated. The Department of Health is committed to acting on the EXPRESS results, published in The Lancetwww.thelancet.com/, and the findings are already being used to redesign stroke prevention services in the UK and elsewhere.

‘If the EXPRESS study was rolled out across the UK, the number of strokes would be reduced by about 10,000 per year, saving the NHS up to £200m in acute care costs alone,’ says Professor Rothwell. The Stroke Association has suggested that the results of the EXPRESS study should be a ‘clarion call’ to all local health providers to make the changes in organisation needed so that everyone who has a TIA gets the stroke prevention treatment that could save their life.

In another paper published in Lancet Neurologywww.thelancet.com/journals/laneur, Dr James Kennedy in the Nuffield Department of Medicine and colleagues reported on the FASTER study, a randomised control trial held in Canada which looked at acute treatment of minor stroke and TIA within hours of the onset of symptoms.

Dr Kennedy said: ‘We were interested to see whether if patients present immediately after symptoms and treatment was commenced immediately, could you change the outcome? It became clear that giving patients aspirin plus clopidogrel (another drug similar to aspirin) appears to reduce the risk of stroke, whereas immediate statin use does not reduce the immediate risk but does reduce the longer-term risk.

‘The FASTER pilot study has produced some interesting results and is a prelude to a larger trial which we are currently setting up.’

In the UK, one in four people will have suffered a stroke by the age of 80. It is the third largest cause of death in the developed world and the single biggest cause of neurological disability.

Dr Kennedy says: ‘Stroke kills 30 per cent of people, it knows no age barrier and is not exclusively a disease of the elderly. We think a lot more can be done to reduce the number of deaths and improve outcomes for patients and we are supportive of the direction of travel proposed in the National Stroke Strategy.’

Professor Rothwell says: ‘There is a very simple and important public education message: seek medical attention immediately after and TIA or minor stroke.‘

Picture: quicker assessment and treatment cuts the risk of a major stroke.

Source: University of Oxford

Explore further: Racial minorities less likely to see a doctor for psoriasis

Related Stories

Racial minorities less likely to see a doctor for psoriasis

December 13, 2017
Despite the fact that their disease may be more severe, a new study shows minorities are less likely than white Americans to see a doctor for psoriasis treatment. Researchers from the Perelman School of Medicine at the University ...

LDL cholesterol found to be the main modifiable predictor of atherosclerosis in individuals with no risk factor

December 11, 2017
LDL cholesterol (LDL-C), known as 'bad' cholesterol, is the underlying reason why many apparently healthy individuals have heart attacks or strokes during middle age despite not having cardiovascular risk factors such as ...

'Death receptors'—New markers for type 2 diabetes and cardiovascular disease

December 12, 2017
Researchers at Lund University in Sweden have found that the presence of death receptors in the blood can be used to directly measure the risk of developing cardiovascular diseases and type 2 diabetes. "We see that people ...

Postmenopausal women should still steer clear of HRT: task force

December 12, 2017
(HealthDay)—Yet again, the nation's leading authority on preventive medicine says postmenopausal women should avoid hormone replacement therapy (HRT).

Clinical trial reveals risky clot busters do not benefit most patients suffering from deep vein thrombosis

December 11, 2017
A clinical trial almost 10 years in the making has revealed that risky, but powerful, clot busting drugs and medical devices do not improve outcomes for patients experiencing deep vein thrombosis (DVT), nor do they prevent ...

Losing weight is hard, but not any harder if you have type 2 diabetes

December 8, 2017
A study has found weight loss could reverse type 2 diabetes. The UK clinical trial showed that 46% of people who followed a low-calorie diet, among other measures, for 12 months were able to stop their type 2 diabetes medications.

Recommended for you

Pickled in 'cognac', Chopin's heart gives up its secrets

November 26, 2017
The heart of Frederic Chopin, among the world's most cherished musical virtuosos, may finally have given up the cause of his untimely death.

Sugar industry withheld evidence of sucrose's health effects nearly 50 years ago

November 21, 2017
A U.S. sugar industry trade group appears to have pulled the plug on a study that was producing animal evidence linking sucrose to disease nearly 50 years ago, researchers argue in a paper publishing on November 21 in the ...

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.