Factsheet by David Gaist

Group Name: Cerebrovascular Disorders
Group leader – clinical and epidemiological research: David Gaist, professor
Department & University/Hospital/Other: Dept. Neurology, Odense University Hospital,

Description of research:
The principal research area of the clinical group is the epidemiology of stroke and other cerebrovascular disorders, particularly associations of these disorders with use of drugs.
Randomized clinical trials (RCTs) are the gold standard for proving drug efficacy. However, RCTs also leave many questions unanswered, e.g., regarding populations not studied in trials, interactions with other drugs or patient characteristics, and long-term effects of drugs beyond the typical trial duration. To bridge this knowledge gap, our group uses real-world data to study potential benefits and adverse effects of drugs on risk or prognosis of cerebrovascular disorders. Additionally, non-neurological effects of drugs that are used to treat or prevent cerebrovascular disorders are also investigated. The long-term goal is to provide evidence that will enhance physicians’ ability to individualize drug treatment for patients with cerebrovascular disorders.


Main current projects
Clinical and epidemiological research:
• Association of common drugs with intracerebral haemorrhage (ICH)
Aim: To evaluate the risk of ICH associated with commonly used drugs with particular focus on concurrent use of multiple drugs (hypothesis driven analyses); further to screen for hitherto unrecognized drug-induced ICH (data driven analyses).

• Subdural haemorrhage (SDH) epidemiology
Aim: To ascertain the impact of increased use of antithrombotic drugs in more recent years on the incidence of SDH; to investigate the impact of antithrombotic drug use on risk or long-term prognosis of SDH.

• Drugs used in secondary cerebrovascular prevention and risk of skin cancer
Aim: To investigate whether drugs used for secondary prevention of cerebrovascular disorders, e.g. antihypertensive drugs, and statins, influence the risk of melanoma or non-melanoma skin cancer.


Key publications, 2017:
Gaist D, García-Rodríguez LA, Hellfritzsch MS, Poulsen FR, Halle B, Hallas J, Pottegård A. Association of antithrombotic drug use with subdural hematoma risk. JAMA 2017; 317: 836-46.

Gaist D, Goldstein LB, Cea Soriano L, García Rodríguez LA. Statins and the risk of intracerebral hemorrhage in patients with history of ischemic stroke or transient ischemic attack. Stroke 2017 Oct 25 Online: https://doi.org/10.1161/STROKEAHA.117.019141

González-Pérez A, Gaist D, de Abajo F, Sáez ME, García-Rodríguez LA. Use of low-dose aspirin after an episode of hemorrhagic stroke is associated with improved survival. Thrombosis and Haemostasis 2017 [In Press]

Key Collaborations:
Danish:
Clinical Pharmacology, Department of Public Health, University of Southern Denmark
The Danish Twin Registry, University of Southern Denmark
Danish Headache Center, Rigshospitalet Glostrup, Copenhagen
Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre
Danish Cancer Society Center, Danish Cancer Society, Copenhagen

International:
Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
Spanish Centre for Pharmacoepidemiologic Research, CEIFE, Madrid, Spain
Department of Biomedical Sciences, School of Medicine and Health Sciences, University of Alcalá, & Unit of Clinical Pharmacology, University Hospital "Príncipe de Asturias", Madrid, Spain