New Cardiff Met research could help predict risk of future strokes

Cardiff Metropolitan University has become the first Welsh university in almost 30 years to be awarded Project Grant funding from the Stroke Association to conduct research which aims to provide critical insight into stroke prevention and treatment after a patient’s first ‘mini-stroke’.

The study, known as PREDICT-EV, will test new biomarkers in patients who suffer a ‘mini-stroke’, otherwise known as a Transient Ischaemic Attack (TIA). The research will be carried out in collaboration with Cwm Taf Morgannwg University Health Board (CTMUHB), where patients will be screened for levels of microscopic vesicles in the blood, that if present in large numbers can render certain patients at significant risk of blood clotting.

Annually, 46,000 British people suffer 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 suffer from 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.

Professor of Cardiovascular Metabolism, Philip James, at Cardiff Metropolitan University, leads the PREDICT-EV team*: “Clinical clotting time assessment is not carried out routinely after a ‘mini-stroke’ but is captured in a small percentage of patients. We wish to take advantage of the fact that 85% 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.”

The £250,000 funding from the Stroke Association will allow researchers at Cardiff Metropolitan University and CTMUHB, to further expand recruitment and follow patients over time, to determine if increased vesicles and altered clotting is evident in patients who go on to suffer a full stroke.

PREDICT-EV is one of five Project Grants announced at the Stroke Association’s flagship event, Amazing Brains, held at the Royal Society of Medicine, London on Thursday 27 April 2023.

Stroke Hub Wales, and the Welsh Government Stroke Implementation Group are delighted to have supported this project from early concept through to fruition. Chair of Stroke Hub Wales, Dr Anne Freeman OBE, commented: “If successful, this project will provide a scientific basis for increased clotting in certain patients that might help clinicians identify patients at highest risk of stroke, thus providing critical insight into stroke prevention and lead for the first time to targeted treatment. Our patient and public involvement team are delighted that this project has been supported and we will monitor its progress with great anticipation.” 

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.

“Our charity has provided support services to Welsh stroke survivors since 2005. 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.”