Secondary Stroke Prevention Health Services and Care


Project: Alberta Stroke Prevention in TIAs and Mild Strokes (ASPIRE).

Principal investigators: Coutts, Shelagh B. (University of Calgary) and Jeerakathil, Thomas J. (University of Alberta)
Co-investigators: Butcher, Ken S. (University of Alberta); Demchuk, Andrew M. (Foothills Medical Centre); Shuaib, Ashfaq (University of Alberta); Watson, Timothy J. (University of Calgary); Majumdar, Sumit R. (University of Alberta); Edmond, Cathy (Foothills Medical Centre).

Dr. Shelagh Coutts is aiming to cut stroke rates in Alberta with a pilot project to test a hotline for mini strokes.
A mini stroke or Transient Ischemic Attack (TIA) happens when a clot stops blood from flowing to the brain for a short time. The symptoms of TIA are almost the same as the symptoms of a stroke except they go away within a few minutes or hours, which is why it can be called a mini-stroke. People who have had a TIA are five times more likely to have a stroke over the next two years than the general population.
According to Dr. Coutts, patients are at the highest risk of having a full stroke within two days of a TIA, although many patients don’t have access to stroke care within that time. She has proposed a telephone hotline to help identify patients at the highest risk to get them the treatment they need in time. “Information taken on this phone call will be used to identify high-risk patients and arrange for them to be seen by a stroke specialist quickly,” she says. “Tests and treatments will happen very fast.”
Her team has sent information cards to doctors’ offices and other medical centres across the province explaining how to classify patients risk after a TIA and providing contact information for a local TIA hotline run by Alberta Health Services.  When a patient arrives with TIA symptoms, the doctor will use the cards to determine if that person is at high risk and then call the hotline to speak to a stroke expert. If the expert determines a high risk level, the patient will be sent to the nearest stroke care centre within 24 hours for a brain scan and signs of blood vessel narrowing.
Dr. Coutts team plans to look at the rate of strokes after TIA before the hotline service and after its implementation to see whether this program is effective. She hopes this method could cut the stroke rate in Alberta while also reducing the gaps between urban and rural healthcare. “All Albertans deserve excellent care and we hope this project can improve the outcomes for all TIA patients in this province.” she says.