prof. dr. A. (Ale) Algra

Professor Emeritus

  • Department of Epidemiology

prof. dr. A. (Ale) Algra


Ale Algra trained in physics at Utrecht University and obtained a BSc in 1975. He continued training at the Medical School of the Erasmus University Rotterdam (MD 1981). In the meantime he worked at the Thoraxcenter on the computer analysis of 24-hour ECGs; originally on technical aspects of ECG-analysis. Later he studied predictors for sudden death from 24-hour ECG, resulting in his doctorate thesis in 1990. In 1984-85 he trained at Harvard School of Public Health (MSc Epidemiology). From 1990 on he works at University Medical Center Utrecht, half-time in the department of Neurology, and half-time in the Julius Center. In 1999-2000 he spent a sabbatical as Visiting Professor at the University of Western Ontario, London, Ontario, Canada, with the research group of Barnett and Hachinski. As of 2005 he works one day per week as professor of clinical epidemiology in the department of Clinical Epidemiology of the Leiden University Medical Center. October 1st, 2015 he was appointed professor of Clinical Epidemiology of Cerebrovascular Diseases at University Utrecht.

Interests and Focus

My main field of research is cerebrovascular disease. I have been involved as principal (co-)investigator in several multicenter secondary prevention trials with antithrombotic treatments, both in patients with cerebral ischaemia and patients after infrainguinal bypass surgery. Within the Julius Center I am one of the principal investigators of the ongoing SMART (Second Manifestations in ARTerial Disease) study, in which currently over 10,000 patients with vascular disease are enrolled. One of my current interests is the difference in coagulation propensity between young patients with ischaemic stroke and myocardial infarction.

Research line and group


Most recent key publications

1: Vlak MHM, Algra A, Brandenburg R, Rinkel GJE. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. Lancet Neurol 2011;10:626-36.
2: van Beijnum J, van der Worp HB, Buis DR, Al-Shahi Salman R, Kappelle LJ, Rinkel GJE, Berkelbach van der Sprenkel JW, Vandertop WP, Algra A, Klijn CJM. Treatment of brain arteriovenous malformations. A systematic review and meta-analysis. JAMA 2011;306:2011-9.
3: Greving JP, Schonewille WJ, Wijman CAC, Michel P, Kappelle LJ, Algra A, on behalf of the BASICS Study Group. Predicting outcome after acute basilar artery occlusion based on admission characteristics. Neurology 2012;78:1058-63.
4: Dorhout Mees SM, Algra A, Vandertop WP, van Kooten F, Kuijsten HAJM, Boiten J, van Oostenbrugge RJ, Al-Shahi Salman R, Lavados P, Rinkel GJE, van den Bergh WM, on behalf of the MASH-2 Study Group. Magnesium for aneurysmal aubarachnoid haemorrhage (MASH-2): a randomised placebo-controlled trial. Lancet 2012;379:44-9
5: Stenting versus medical treatment in patients with symptomatic vertebral artery stenosis: a randomised open-label phase 2 trial Compter A, van der Worp HB, Schonewille WJ, Vos JA, Boiten J, Nederkoorn PJ, Uyttenboogaart M, Lo RT, Algra A, Kappelle LJ, for the VAST InvestigatorsLancet Neurol, 2015;14:606-14

Side Activities

  • Member Scientific Advisory Committee of the ESO Conference.
    Member Data Monitoring Committee TO-ACT trial (J. Stam, principal investigator).
    Member editorial board Stroke.
    Independent chairman Carotid Stenting Trialists’ Collaboration: pooled analysis of individual patient data from RCTs on stenting versus endarterectomy for symptomatic carotid stenosis.
    Member Scientific Advisory Board Center for Stroke Research, Charité, Berlin, Germany.
    Editor Cochrane Stroke Group (P. Sandercock, editor-in-chief).


Fellowship and Awards

  • 1: Netherlands Heart Foundation: educational grant MSc HSPH

Research Output (785)

Smoking cessation and risk of recurrent cardiovascular events and mortality after a first manifestation of arterial disease

van den Berg M. Johannek E., van der Graaf Yolanda, Deckers Jaap W., de Kanter Wanda, Algra Ale, Kappelle L. Jaap, de Borst Gert J., Cramer Maarten-Jan M., Visseren Frank L. J., Grobbee D. E., Rutten G. E. H. M., Leiner T., Nathoe H. M., 1 jul 2019, In: American Heart Journal. 213 , p. 112-122 11 p.

Stenting for symptomatic vertebral artery stenosis: a preplanned pooled individual patient data analysis

Markus Hugh S., Harshfield Eric L., Compter Annette, Kuker Wilhelm, Kappelle L. Jaap, Clifton Andrew, van der Worp H. Bart, Rothwell Peter, Algra Ale 1 jul 2019, In: Lancet Neurology. 18 , p. 666-673 8 p.

Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies

Wilson Duncan, Ambler Gareth, Lee Keon-Joo, Lim Jae-Sung, Shiozawa Masayuki, Koga Masatoshi, Li Linxin, Lovelock Caroline, Chabriat Hugues, Hennerici Michael, Wong Yuen Kwun, Mak Henry Ka Fung, Prats-Sanchez Luis, Martinez-Domeno Alejandro, Inamura Shigeru, Yoshifuji Kazuhisa, Arsava Ethem Murat, Horstmann Solveig, Purrucker Jan, Lam Bonnie Yin Ka, Wong Adrian, Kim Young Dae, Song Tae-Jin, Schrooten Maarten, Lemmens Robin, Eppinger Sebastian, Gattringer Thomas, Uysal Ender, Tanriverdi Zeynep, Bornstein Natan M., Ben Assayag Einor, Hallevi Hen, Tanaka Jun, Hara Hideo, Coutts Shelagh B., Hert Lisa, Polymeris Alexandros, Seiffge David J., Lyrer Philippe, Algra Ale, Kappelle Jaap, Salman Rustam Al-Shahi, Jager Hans R., Lip Gregory Y. H., Mattle Heinrich P., Panos Leonidas D., Mas Jean-Louis, Legrand Laurence, Karayiannis Christopher, Phan Thanh, 1 jul 2019, In: Lancet Neurology. 18 , p. 653-665 13 p.

Gadolinium Enhancement of the Aneurysm Wall in Unruptured Intracranial Aneurysms Is Associated with an Increased Risk of Aneurysm Instability:A Follow-Up Study

Vergouwen M D I, Backes D, van der Schaaf I C, Hendrikse J, Kleinloog R, Algra A, Rinkel G J E jul 2019, In: American Journal of Neuroradiology. 40 , p. 1112-1116 5 p.

Antiplatelet Therapy After Noncardioembolic Stroke:An Individual Patient Data Network Meta-Analysis

Greving Jacoba P., Diener Hans-Christoph, Reitsma Johannes B., Bath Philip M., Csiba Laszlo, Hacke Werner, Kappelle L. Jaap, Koudstaal Peter J., Leys Didier, Mas Jean-Louis, Sacco Ralph L., Algra Ale jul 2019, In: Stroke. 50 , p. 1812-1818 7 p.

Definition and Prioritization of Data Elements for Cohort Studies and Clinical Trials on Patients with Unruptured Intracranial Aneurysms: Proposal of a Multidisciplinary Research Group

Hackenberg Katharina A. M., Algra Ale, Salman Rustam Al-Shahi, Frosen Juhana, Hasan David, Juvela Seppo, Langer David, Meyers Philip, Morita Akio, Rinkel Gabriel, Etminan Nima, Suarez Jose I., Macdonald R. Loch, Amin-Hanjani Sepideh, Brown Robert D., Jr., Manoel Airton Leonardo de Oliveira, Derdeyn Colin P., Etminan Nima, Keller Emanuela, LeRoux Peter D., Mayer Stephan, Morita Akio, Rinkel Gabriel, Rufennacht Daniel, Stienen Martin N., Torner James, Vergouwen Mervyn D. I., Wong George K. C., Bijlenga Philippe, Ko Nerissa, McDougall Cameron G., Mocco J., Murayama Yuuichi, Werner Marieke J. H., Mayer Stephan, Suarez Jose I., Damani Rahul, Broderick Joseph, Dhar Raj, Jauch Edward C., Kirkpatrick Peter J., Martin Renee H., Mocco J., Vergouwen Mervyn D. I., Ruigrok Ynte, Rinkel Gabriel, Rinkel Gabriel, Algra Ale, Vergouwen Mervyn D. I., Visser-Meily Johanna, 16 jun 2019, In: Neurocritical Care. 30 , p. 87-101 15 p.

Stroke progression and clinical outcome in ischemic stroke patients with a history of migraine

Mulder Inge A, Holswilder Ghislaine, van Walderveen Marianne Aa, van der Schaaf Irene C, Bennink Edwin, Horsch Alexander D, Kappelle L Jaap, Velthuis Birgitta K, Dankbaar Jan Willem, Terwindt Gisela M, Schonewille Wouter J, Visser Marieke C, Ferrari Michel D, Algra Ale, Wermer Marieke Jh, 27 mei 2019, In: International Journal of Stroke. 14 , p. 946-955 10 p.

Combining Neurovascular and Neurodegenerative Magnetic Resonance Imaging Measures in Stroke

Wyss Annick, Dawson Jesse, Arba Francesco, Wardlaw Joanna M., Dickie David Alexander, Diener H. C., Algra A., Davis S., Hankey G., Lees K. R., Ovbiagele B., Weir C. mei 2019, In: Stroke. 50 , p. 1136-1139 4 p.

Stress in Patients With (Un)ruptured Intracranial Aneurysms vs Population-Based Controls

de Wilde Arno, Greebe Paut, Rinkel Gabriel J. E., Algra Ale mei 2019, In: Neurosurgery. 84 , p. 1065-1071

Long-term outcomes of stenting and endarterectomy for symptomatic carotid stenosis:a preplanned pooled analysis of individual patient data

Brott Thomas G., Calvet David, Howard George, Gregson John, Algra Ale, Becquemin Jean Pierre, de Borst Gert J., Bulbulia Richard, Eckstein Hans Henning, Fraedrich Gustav, Greving Jacoba P., Halliday Alison, Hendrikse Jeroen, Jansen Olav, Voeks Jenifer H., Ringleb Peter A., Mas Jean Louis, Brown Martin M., Bonati Leo H., 1 apr 2019, In: The Lancet Neurology. 18 , p. 348-356 9 p.

All Research Output (785)