prof. dr. A. (Ale) Algra

prof. dr. A. (Ale) Algra

Professor Emeritus
prof. dr. A. (Ale) Algra
  • Department of Epidemiology



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 (793)

Antihypertensive treatment and risk of cancer:an individual participant data meta-analysis

Copland Emma, Canoy Dexter, Nazarzadeh Milad, Bidel Zeinab, Ramakrishnan Rema, Woodward Mark, Chalmers John, Teo Koon K., Pepine Carl J., Davis Barry R., Kjeldsen Sverre, Sundström Johan, Rahimi Kazem, Adler A., Agodoa L., Algra A., Asselbergs F. W., Beckett N., Berge E., Black H., Brouwers F. P.J., Brown M., Bulpitt C. J., Byington B., Chalmers J., Cushman W. C., Cutler J., Davis B. R., Devereaux R. B., Dwyer J., Estacio R., Fagard R., Fox K., Fukui T., Gupta A. K., Holman R. R., Imai Y., Ishii M., Julius S., Kanno Y., Kjeldsen S. E., Kostis J., Kuramoto K., Lanke J., Lewis E., Lewis J., Lievre M., Lindholm L. H., Patel A., Wang J., apr 2021, In: The Lancet Oncology. 22 , p. 558-570 13 p.

Development of imaging-based risk scores for prediction of intracranial haemorrhage and ischaemic stroke in patients taking antithrombotic therapy after ischaemic stroke or transient ischaemic attack:a pooled analysis of individual patient data from cohort studies

Best Jonathan G, Ambler Gareth, Wilson Duncan, 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, Martínez-Domeño Alejandro, Inamura Shigeru, Yoshifuji Kazuhisa, Arsava Ethem Murat, Horstmann Solveig, Purrucker Jan, Lam Bonnie Yin Ka, Wong Adrian, Kim Young Dae, Song Tae-Jin, Lemmens Robin, Eppinger Sebastian, Gattringer Thomas, Uysal Ender, Tanriverdi Zeynep, Bornstein Natan M, Ben Assayag Einor, Hallevi Hen, Molad Jeremy, Nishihara Masashi, Tanaka Jun, Coutts Shelagh B, Polymeris Alexandros, Wagner Benjamin, Seiffge David J, Lyrer Philippe, Algra Ale, Kappelle L Jaap, Al-Shahi Salman Rustam, Jäger Hans R, Lip Gregory Y H, Fischer Urs, El-Koussy Marwan, Mas Jean-Louis, Legrand Laurence, Hendrikse Jeroen, apr 2021, In: Lancet Neurology. 20 , p. 294-303 10 p.

Absence of Consistent Sex Differences in Outcomes From Symptomatic Carotid Endarterectomy and Stenting Randomized Trials

Howard Virginia J, Algra Ale, Howard George, Bonati Leo H, de Borst Gert J, Bulbulia Richard, Calvet David, Eckstein Hans-Henning, Fraedrich Gustav, Greving Jacoba P, Halliday Alison, Hendrikse Jeroen, Jansen Olav, Brown Martin M, Mas Jean-Louis, Ringleb Peter A, Brott Thomas G, feb 2021, In: Stroke. 52 , p. 416-423 8 p.

Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage in Patients With a History of Migraine

van Os Hendrikus J A, Ruigrok Ynte M, Verbaan Dagmar, Dennesen Paul, Müller Marcella C A, Coert Bert A, Algra Ale, Vergouwen Mervyn D I, Wermer Marieke J H 1 sep 2020, In: Stroke. 51 , p. 3039-3044 6 p.

Location specific risk factors for intracerebral hemorrhage:Systematic review and meta-analysis

Jolink Wilmar M T, Wiegertjes Kim, Rinkel Gabriël J E, Algra Ale, de Leeuw Frank-Erik, Klijn Catharina J M 20 jul 2020, In: Neurology. 95 , p. e1807-e1818

Cost-benefit of outcome adjudication in nine randomised stroke trials

Godolphin Peter J, Bath Philip M, Algra Ale, Berge Eivind, Chalmers John, Eliasziw Misha, Hankey Graeme J, Hosomi Naohisa, Ranta Annamarei, Weimar Christian, Woodhouse Lisa J, Montgomery Alan A 10 jul 2020, In: Clinical Trials. 17 , p. 576-580 5 p.

Refining prediction of major bleeding on antiplatelet treatment after transient ischaemic attack or ischaemic stroke

Hilkens Nina A., Li Linxin, Rothwell Peter M., Algra Ale, Greving Jacoba P. 1 jun 2020, In: European Stroke Journal. 5 , p. 130-137 8 p.

Confounding adjustment performance of ordinal analysis methods in stroke studies

Zonneveld Thomas P, Aigner Annette, Groenwold Rolf H H, Algra Ale, Nederkoorn Paul J, Grittner Ulrike, Kruyt Nyika D, Siegerink Bob 16 apr 2020, In: PLoS ONE. 15 10 p.

Timing of procedural stroke and death in asymptomatic patients undergoing carotid endarterectomy:individual patient analysis from four RCTs

Poorthuis M H F, Bulbulia R, Morris D R, Pan H, Rothwell P M, Algra A, Becquemin J-P, Bonati L H, Brott T G, Brown M M, Calvet D, Eckstein H-H, Fraedrich G, Gregson J, Greving J P, Hendrikse J, Howard G, Jansen O, Mas J-L, Lewis S C, de Borst G J, Halliday A, 12 mrt 2020, In: British Journal of Surgery. 107 , p. 662-668 7 p.

Distribution of Cardioembolic Stroke:A Cohort Study

Pierik Ramon, Algra Ale, van Dijk Ewoud, Erasmus Michiel E, van Gelder Isabella C, Koudstaal Peter J, Luijckx Gert-Jan R, Nederkoorn Paul J, van Oostenbrugge Robert J, Ruigrok Ynte M, Scheeren Thomas W L, Uyttenboogaart Maarten, Visser Marieke C, Wermer Marieke J H, van den Bergh Walter M, 21 jan 2020, In: Cerebrovascular Diseases. 49 , p. 97-104 8 p.

All research output

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