What is the issue for NSW?
Ischaemic stroke occurs when a blood clot blocks a brain artery therefore cutting off the blood supply to the brain. It affects nearly 50,000 Australians each year, and more than 25% of survivors have another stroke within a year. Around 30% of stroke patients don’t have a clear cause for their stroke. A heart condition called atrial fibrillation is known to cause a quarter of these strokes, but it’s not always easy to detect. When the cause of a stroke is unclear, it is referred to as ‘embolic stroke of uncertain source’. While blood thinners are better at preventing strokes in people with atrial fibrillation, they don’t work as well for all patients who have suffered an embolic stroke of uncertain source, so it’s crucial to find out who needs this treatment. There is growing evidence that atrial fibrillation might be a sign of damage in the heart’s upper chambers (atria), which makes blood clots more likely. Advanced heart imaging techniques, like cardiac computed tomography scans, are showing promise in finding these clots.
What does the research aim to do and how?
Cardiac computed tomography scans look at the heart while the patient is also getting a brain computed tomography scan. It only adds a few minutes to the process but greatly improves the chances of finding if the stroke was caused by a problem with the heart. Our goal is to find where clots come from in stroke patients to prevent future strokes. Advancements in cardiac computed tomography scans make this possible. An international group was formed to share data and expertise and will study how different treatments affect stroke recurrence in patients with heart clots. The group will also compare blood thinners with other drugs.
The top three key measures/indicators being used to assess the research outcomes are:
- Hyperacute heart computed tomography scans will identify stroke patients likely to have clots coming from the heart. This will allow doctors to prescribe the best medication for those patients.
- We will know how often strokes reoccur in patients who had a stroke because of a blood clot in the heart. The data from this study will be used to plan an international trial that compares different treatments to prevent repeat strokes.
- The research will be able to explain how often atrial myopathy (a heart condition) occurs in people who have had a stroke. This will contribute to quickly identify atrial myopathy and to treat it.