World’s largest screening project to launch in Australia to prevent disabling strokes

07/06/21

HRI’s Professor Ben Freedman, Dr Nicole Lowres and Dr Katrina Giskes have received a significant Medical Research Future Fund (MRFF) grant that is poised to transform Australia’s stroke-related healthcare. The trials will be coordinated by the NHMRC Clinical Trials Centre at The University of Sydney under the guidance of Professors Anthony Keech and John Simes.

 

Atrial fibrillation (AF) is the most common abnormal heart rhythm, causing one in three strokes that are often severe and largely preventable. AF prevalence rises with age, affecting about 10 per cent of people aged 70 and over, and increases their stroke risk by five times.

One in 10 people who experienced stroke were unaware they had AF at the time of stroke, as AF can be a silent condition that produces no symptoms. By detecting AF early with more intense electrocardiogram (ECG) screening, combined with treatment with oral anticoagulants, the risk of stroke can be reduced by 64 per cent.

“The MRFF grant couldn’t have come at a better time. We will use the funds over the next five years to AF screen 70 year olds and upwards, to provide definitive evidence if more intensive ECG screening prevents stroke, morbidity and death,” explained Professor Freedman, from HRI and The University of Sydney’s Charles Perkins Centre.

“The results will impact current screening guidelines to prevent stroke and improve stroke-related healthcare.”

The research project, known as SAFER-AUS, will run as the Australian extension of the UK SAFER study run by the University of Cambridge. Plans are underway to recruit 36 general practices in three states for randomised testing for AF on a sample of patients aged 70 and over, using a novel Zenicor thumb-ECG device to record heart rhythm four times daily for three weeks. After recruiting a sample of their patients aged 70 or more, practices will be randomised to either the active screening or control arm to avoid bias.

Once a cardiologist diagnoses AF on a screening ECG, patients will be asked to visit their GP practice to discuss care and management.

“We are excited by the potential health impact this far-reaching research will have on everyday lives in Australia and the UK.”

The trials will be coordinated by the NHMRC Clinical Trials Centre at The University of Sydney under the guidance of Professors Anthony Keech and John Simes. In addition to this, HRI is collaborating with multiple partners on this pioneering project in Australia and the UK.

Professor Mark Nelson is Senior Professorial Fellow at Menzies Institute for Medical Research, Professor and Chair, Discipline of General Practice, University of Tasmania and holds an Adjunct Professorial position with the Department of Epidemiology and Preventive Medicine at Monash University.
Professor Anthony Keech is Professor of Medicine, Cardiology and Epidemiology at the University of Sydney and Senior Associate Director of the NHMRC Clinical Trials Centre at the University of Sydney.
Professor Charlotte Hespe is Head of General Practice and Primary Care Research for University of Notre Dame Australia, and Chair of the Royal Australasian College of General Practice (RACGP) NSW/ACT Faculty Council and a national RACGP Director.
Professor Dominique Cadilhac is Professor (Research) and Head of Translational Public Health: Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash University. She is also Head of Public Health, Stroke Division – Florey Institute of Neuroscience and Mental Health.
Professor Jonathan Mant is Professor of Primary Care Research at the University of Cambridge, an honorary consultant in Public Health for Public Health England and an honorary consultant for Addenbrooke’s Hospital.
Dr Michael Sweeting is Associate Professor of Biostatistics at the University of Leicester. He also holds honorary contracts with the Department of Public Health and Primary Care at the University of Cambridge and with Public Health England.
Professor Vincent Thijs is a Professorial Fellow at Florey Institute of Neuroscience and Mental Health, University of Melbourne. He is also Head of Stroke at Austin Health, Victoria, and co-director of the Australian Cardiovascular Alliance Clinical Trials Flagship.
Professor John Simes is Senior Principal Research Fellow and Founding Director of the NHMRC Clinical Trials Centre at The University of Sydney.
Professor Christopher Reid is a Principal Research Fellow based in Curtin University in Western Australia and is Chair of the Australian New Zealand Cardiovascular Trials Alliance (ANZACT) network and co-director of the Australian Cardiovascular Alliance Clinical Trials Flagship.