Background
The occurrence of thrombotic complications, such as in the case of an ischaemic stroke, represent an imbalance between the pro-thrombotic and fibrinolytic equilibrium. Currently, the focus has been on thrombotic profiles and how we can identify and effectively reduce the thrombotic potential of these ‘at-risk’ patients to reduce the morbidity and mortality associated with stroke. However, some risk factors predisposing patients to thrombotic complications also increase the risk of bleeding thereby limiting their potential in a risk stratification tool. Endogenous fibrinolysis is a novel biomarker which has shown promise in identifying high risk patients who may benefit from more aggressive monitoring and management following their thrombotic event. Being able to provide more precise risk stratification will be beneficial in optimising personalised treatment to maintain the fine balance of benefit and risk of harm in a population of mainly multimorbid and frail people.
Objectives
1. To assess the difference in biomarkers of endogenous fibrinolysis in patients presenting with stroke with or without the presence of atrial fibrillation (AF)
2. To determine the role of endogenous fibrinolysis in identifying incidence of AF in a post-stroke population
3. To assess the added benefit of the assessment of endogenous fibrinolysis beyond clinical parameters in risk stratification of patients post-stroke
Experimental approach
This will be a sub-study of a funded project involving the recruitment of patients presenting to hospitals with acute stroke. Blood will be obtained from the patient on admission and 6 months later to assess their fibrinolytic status using the Global Thrombosis Test (GTT) and other markers of fibrinolysis. Basic demographics, medical, drug and social history will be obtained on admission and patients will have follow up to assess the incidence of newly diagnosed AF and major adverse events (such as all cause and cardiovascular mortality, stroke, myocardial infarction and heart failure). Data analysis will ascertain if the assessment of fibrinolytic status can aid in the predicting the risk of developing atrial fibrillation in a post-stroke population.
Applicant Information
The successful applicant should have an interest in cardiovascular disease and thrombosis and a minimum 2:1 in a science or health-related subject The successful applicant will be trained during the PhD in both bench and bedside skills, which are essential for a clinical research career. The project provides the opportunity to gain skills and training in performing literature searches, understanding pathophysiology of thrombosis, handling and processing of blood samples, statistical analyses, academic writing skills, as well as relevant interpersonal skills like patient interaction and working as part of a multidisciplinary research team.
For any enquiries please contact Ying X. Gue on: [Email Address Removed]
To apply, please email your CV with a cover letter to Ying X.Gue on: [Email Address Removed]
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