Urgent secondary prevention after transient ischaemic attacks and minor stroke
Research at the University of Oxford's Stroke Prevention Research Unit (SPRU), led by Professor Peter Rothwell, radically changed how transient ischaemic attacks (TIAs) and minor strokes are managed. It led to these 'warning' events being rebranded as a medical emergency in all clinical guidelines, including NICE, re-emphasis in international guidelines and the National Stroke Strategy mandating the rapid implementation of urgent treatment. Approximately 70,000 strokes have been prevented since 2013 in the UK alone saving the NHS GBP200,000,000 per year in acute stroke care costs, and further improvements in management.
In addition, the University of Oxford SPRU research found that the substantial benefit of urgent investigation and treatment was due primarily to the early use of antiplatelet drugs. Aspirin was shown to more than halve the risk of a subsequent major stroke, leading to the recommendation of immediate aspirin prior to specialist assessment in clinical practice guidelines and public / patient information sources.
Finally, the University of Oxford algorithm for identifying individuals at particularly high risk of stroke after a TIA (the ABCD2 score) enabled planning of health services while clinical resources were scarce and has led to new guidelines on the targeted use of dual antiplatelet therapy.