New H2020 project: PRESTIGE AF

New H2020 project : PRESTIGE AF

PREvention of STroke in Intracerebral hemorrhaGE survivors with Atrial Fibrillation

Intracerebral hemorrhage (ICH) is a severe stroke subtype causing higher mortality and more disability than other strokes. 20% of ICH survivors have atrial fibrillation (AF), a major cause of ischemic stroke (IS). While IS in AF patients is generally prevented by oral anticoagulants (OAC), their use in ICH survivors is uncertain due to increased bleeding risk. No evidence from randomized controlled trials (RCT) is available addressing this dilemma. Personalized risk prediction is desirable to balance benefits of OAC against bleeding risk for individualized prevention.
Objectives: (1) To perform the first sufficiently powered RCT in ICH survivors with AF testing if direct OAC are superior for IS prevention and non-inferior regarding ICH recurrence versus antiplatelet or no antithrombotic therapy (2) To personalize antithrombotic prevention by multidimensional risk modeling (3) To estimate population impact of trial outputs on health economic consequences and generalizability to European population (4) To explore patient-centered aspects including
adherence, attitudes towards antithrombotic therapy and gender imbalances in trial enrollment.

PRESTIGE-AF addresses the unmet need of best antithrombotic stroke prevention in ICH patients with AF. Recurrent stroke reduces individual life expectancy, quality of life and has high public health impact. Work packages integrating biological data will generate new tools to tailor prevention. Modeling of economic and societal consequences and replication in real-life settings will estimate population impact.


Three LIN members have defended their doctoral thesis

In april and may three LIN members have defended their doctoral thesis.

Victor Llombart:  «Aplicaciones proteómicas para el descubrimiento de biomarcadores diagnósticos en ictus»

Alejandro Bustamante: «Condicionantes pronósticos del ictus isquémico: utilidad de los biomarcadores sanguíneos en su predicción»

Cristina Merino: «Identificación de biomarcadores en el ictus hemorrágico y su estudio funcional en modelos experimentales»

Congratulations to all of them!


Thesis: “Usefulness of biomarkers in the diagnosis of silent cerebrovascular disease”

Andrea Vilar defended her Thesis “Usefulness of biomarkers in the diagnosis of silent cerebrovascular disease” on the 4th of February 2016 getting the highest score. Later we shared some meals and drinks and she got interesting presents such as a nice hat full of “microinfarcts” and “microbleeds” and a teaching course to prepare Gin-Tonics. Good luck in your postdoctoral stage Andrea¡¡¡

First chinese student becomes Doctor at VHIR

First chinese student becomes Doctor at VHIR

China Scholarship Council (CSC) is periodically launching a call for granting talented chinese students to go abroad  to conduct their doctoral studies in foreign countries.

LIN has come up with one of these students, Feifei Ma, who has been doing her research work under the supervision of Dr. Anna Rosell and Dr. Joan Montaner.

She has been the first student with this kind of grant who has defended the thesis in the Institute of Research Vall d’Hebron.

The defence of the thesis under the tittle “Dual role of matrix metalloproteinases in brain injury and neurorepair after cerebral ischemia” took place on november  30th  2015 and she has got the maximum qualification.

LIN will coordinate a project funded by La Marató de TV3 in its 2014 edition.

TITLE:   Atrial Fibrillation Research in Catalonia (AFRICAT): Sequential Clinic-Electro-Biological Screening among high risk individuals.


It is a coordinated project with three subprojects:


  • Joan Montaner Villalonga

Institut de Recerca Hospital Universitari Vall d’Hebron

  • Ángel Alonso Pedrote Martínez

Hospitales Universitarios Virgen del Rocío – Sevilla

  • Josep Lluís Clua Espuny

CAP El Temple – Institut Català de la Salut – Tortosa



Atrial fibrillation (AF) is one the major causes of morbidity and mortality, and it increases death risk, congestive heart failure and the risk for systemic embolism, including stroke. AF diagnosis is a challenge because of its paroxysmal nature, especially at the initial phases of the disease. Improvements in AF detection would have a massive beneficial impact in healthcare systems. However, systematic screening programs have failed to show a clear benefit.

In this project we will create and apply a sequential screening program in a high-risk population by integrating clinical, electrocardiographic and biological information. The study will be therefore divided into 2 different phases of generation and validation of the screening program.

In the first phase, 100 patients will receive a comprehensive assessment to evaluate which variables would be the best in predicting AF. In these patients we will complete clinical assessment, testing of different pulse devices for AF screening, discovery of blood biomarkers for AF by aptamers technology and RNA expression, and validation of biological candidates from the literature and our previous results. AF diagnosis will be based on detection in 4-week Holter-EKG monitoring.

In the second phase, we will apply the best candidates in a sequential screening program in a high-risk population of our health area (aged 75-85 with hypertension and diabetes). The screening will consist of selection of the highest-risk patients by clinical variables and performing of pulse device detection. Biomarkers will be measured in the negative cases to perform Holter-EKG monitoring in the highest-risk patients. In the final step of the study, cost-efficacy analyses will be carried out.

This screening program could be applied at the community level, having a wide social and economical impact in terms of reduction of cardiovascular mortality, disability due to stroke and heart failure, and reduction of the related costs.

International collaboration between VHIR and UAB for Cerebral Infarction treatment


The Neurovascular Diseases group of Vall d’hebron Institute of Research (VHIR) and the Institut de Neurociències UAB have signed a collaborative agreement with the Japanese company R-Tech Ueno, to develop a novel VAP-1 inhibitor for treatment of cerebral infarction.

RTU-009 is a novel VAP-1 inhibitor, having an anti-inflammatory and neuroprotective effect. It is confirmed that RTU-009 has a neuroprotective effect similar to Edaravone, the brain protective agent, and a cerebral dysfunction improving effect when applied in combination with t-PA treatment in animal stroke models. It is currently undergoing non-clinical studies to proceed to Phase I clinical trials. Though an oral VAP-1 inhibitor named RTU-1096 is under development, RTU-009 is the novel VAP-1 inhibitor that has been developed as an injection agent targeting for treatment of acute cerebral infarction. To explore the possibility of the clinical application of RTU-009 for treating cerebral infarction as a POC (Proof of Concept) trials (Early Phase II clinical trials), we started collaborative research using stroke animal models with the group led by Professor Unzeta of the Institute of Neuroscience, UAB, and the group led by Dr. Montaner, of Vall d’Hebron Institute of Research, the research centre of the UAB-affiliated Vall d’Hebron University Hospital, who are active in the front line of clinicalas well as research activity. Going forward, they will proceed with the development of RTU-009 as acombinationwith t-PA treatment for acute cerebral infarction as the top priority target. These initiatives, including early clinical trials, will be conducted in collaboration with academia.

For the acute stage of cerebral infarction, thrombolytic treatment usingt-PA is the first-line therapy;however,t-PAcan only be used for patients within 4.5 hours from the onset of stroke, considering the risk of brain hemorrhage. Therefore, it is extremely important to develop a new treatment method that reduces the risk of brain hemorrhage and enlarges the range of target patients. According to somereports, the recovery rate, representing the rate of patients who recover to the level of self-reliance, with t-PA treatment is 40-50% in Japan. Further enhancement of the recovery rate and expansion of the 4.5-hour time window for treatment are strongly desired in clinical practice, and we may achieve such goals by utilizing RTU-009 as combinationwith t-PA treatment. In addition, it wasrecently reported that removingthe thrombus intreatable patients within 6 hours of stroke onset via endovascular treatment (mechanical thrombus collection therapy or endovascular thrombectomy) improves treatment results as compared with conventional treatments. Based on this report, we would like to also explore a new treatment utilizing RTU-009, which has an anti-inflammatory effect,in combination with endovascular treatment.