Vascular studies

In a recent survey, Valentin and Bass (2004) showed the impact in various pharmaceutical companies. The types of safety pharmacology studies conducted are different. During the pre-candidate drag selection phase primarily in vitro and in vivo vascular studies were conducted. The focus in these studies was on... 

The incidence of new cases of first-ever TIA or stroke can only be reliably assessed in prospective population-based studies (Sudlow and Warlow 1996 Feigin et al. 2003 Rothwell et al. 2004) since hospital-based studies are subject to referral bias (Table 1.4). One of the most comprehensive population-based studies of stroke and TIA incidence is the Oxford Vascular Study, OXVASC, which has near-complete case ascertainment of all patients, irrespective of age, in a population of 91 000 defined by registration with nine general practices in Oxfordshire, UK (Coull et al 2004). This is in contrast to previous studies, such as the MONICA project and the Framingham study, which had an age cut-off at 65 or 75 years or relied on voluntary participation. 

Rothwell PM, Coull AJ, Giles MF et al. (2004). Change in stroke incidence, mortality, case-fatality, severity and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet 363 1925-1933 Rothwell PM, Coull AJ, Silver LE et al. (2005). Population-based study of event-rate, incidence, case fatality and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study). 

Lovelock GE, Molyneux AJ, Rothwell PM For the Oxford Vascular Study (2007). Ghange in incidence and aetiology of intracerebral haemorrhage in Oxfordshire, UK, between 1981 and 2006 a population-based study. Lancet Neurology 6 487-493... 

OXVASC, Oxford Vascular Study OCSP, Oxford Community Stroke Project Cl, confidence interval. 

Table 8.2. Numbers of patients referred to dedicated TIA clinics" in whom a non-neurovascular diagnosis was eventually made in Oxford Vascular Study (OXVASC 2002-2004) and the Oxford Community Stroke Project (OCSP 1981-1986)...

Fig. 10.1. Numbers of patients referred to the Oxford Vascular Study (OXVASC) between 2002 and 2007 with suspected transient ischemic attack (TIA) or minor stroke showing clinical diagnosis (before imaging) and revised...

Table 10.3. Rates of infarction, primary hemorrhage or hemorrhagic infarction on CT scan among subjects with probable or definite transient ischemic attack or minor stroke in the Oxford Vascular Study (OXVASC)...

Comparable risks of stroke after TIA were measured in population-based studies in Oxfordshire, UK (Lovett et al. 2003 Coull et al. 2004). In a cohort of 249 consecutive patients with a TIA ascertained in the Oxford Vascular Study (OXVASC) over a 30-month period, stroke risks at two and seven days were 6.8% (95% confidence interval [Cl], 3.7-10.0) and 12.0% (95% Cl, 8.0-16.1), respectively (Rothwell et al. 2007). Although this cohort was smaller than the Californian cohort, it had the advantages of being population based and, therefore, included patients who were treated as inpatients, as outpatients and managed solely in primary care diagnoses were made by an experienced stoke physician and follow-up was face to face with independent adjudication of outcome events. 

Fig. 15.2. Stroke-free survival curves for consecutive patients with transient ischemic attacks (TIAs) and anterior (—) versus posterior (—) circulation events in the Oxford Vascular Study (OXVASQ (log rank p = 0.04) (Flossman et al. 2006).

Lovett JK, Coull A, Rothwell PM on behalf of the Oxford Vascular Study (2004). Early risk of recurrent stroke by aetiological subtype implications for stroke prevention. Neurology 62 569-574... 

O Reilly, S. M., Rustin, G. J. S., Farmer, K., Burke, M Hill, S., and Denekamp, J. (1993) Flavone acetic acid (FAA) with recombinant interleukin-2 (rIL-2) in advanced malignant melanoma. 1. Clinical and vascular studies. Br. J. Cancer 67,1342-1345. 

Beaule PE, Campbell PA, Hoke R, Dorey F. Notching of the femoral neck during resurfacing arthroplasty of the hip a vascular study. J Bone Joint Surg Br 2006 88(l) 35-9. 

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