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)

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.

A support programme for secondary prevention in patients with transient ischaemic attack and minor stroke (INSPiRE-TMS): an open-label, randomised controlled trial

Ahmadi Michael, Laumeier Inga, Ihl Thomas, Steinicke Maureen, Ferse Caroline, Endres Matthias, Grau Armin, Hastrup Sidsel, Poppert Holger, Palm Frederick, Schoene Martin, Seifert Christian L., Kandil Farid I., Weber Joachim E., von Weitzel-Mudersbach Paul, Wimmer Martin L. J., Algra Ale, Amarenco Pierre, Greving Jacoba P., Busse Otto, Kohler Friedrich, Marx Peter, Audebert Heinrich J. jan 2020, In: Lancet Neurology. 19 , p. 49-60 12 p.

Associations of Perioperative Variables With the 30-Day Risk of Stroke or Death in Carotid Endarterectomy for Symptomatic Carotid Stenosis

Knappich Christoph, Kuehnl Andreas, Haller Bernhard, Salvermoser Michael, Algra Ale, Becquemin Jean Pierre, Bonati Leo H., Bulbulia Richard, Calvet David, Fraedrich Gustav, Gregson John, Halliday Alison, Hendrikse Jeroen, Howard George, Jansen Olav, Malas Mahmoud B., Ringleb Peter A., Brown Martin M., Mas Jean Louis, Brott Thomas G., Morris Dylan R., Lewis Steff C., Eckstein Hans Henning 1 dec 2019, In: Stroke. 50 , p. 3439-3448 10 p.

Intrinsic Coagulation Pathway, History of Headache, and Risk of Ischemic Stroke

van Os Hendrikus J. A., Wermer Marieke J. H., Rosendaal Frits R., Govers-Riemslag Jose W., Algra Ale, Siegerink Bob S. 1 aug 2019, In: Stroke. 50 , p. 2181-2186 6 p.

Secular Trends in Procedural Stroke or Death Risks of Stenting Versus Endarterectomy for Symptomatic Carotid Stenosis A Pooled Analysis of Randomized Trials

Müller Mandy D, von Felten Stefanie, Algra Ale, Becquemin Jean-Pierre, Bulbulia Richard, Calvet David, Eckstein Hans-Henning, Fraedrich Gustav, Halliday Alison, Hendrikse Jeroen, Howard George, Gregson John, Jansen Olav, Brown Martin M, Mas Jean-Louis, Brott Thomas G, Ringleb Peter A, Bonati Leo H aug 2019, In: Circulation. Cardiovascular Interventions. 12

Outcome Assessment by Central Adjudicators Versus Site Investigators in Stroke Trials: A Systematic Review and Meta-Analysis

Godolphin Peter J., Bath Philip M., Algra Ale, Berge Eivind, Brown Martin M., Chalmers John, Duley Lelia, Eliasziw Misha, Gregson John, Greving Jacoba P., Hankey Graeme J., Hosomi Naohisa, Johnston S. Claiborne, Patsko Emily, Ranta Annamarei, Sandset Per Morten, Serena Joaquin, Weimar Christian, Montgomery Alan A., Knipp S. C., Giugliano R. P., Bonati L. H., Nagai Y., Matsumoto M., Barnett H. J. M., Fox A. J., Farrant M., Easton J. D., Elm J. J., Neal B., Arima H., Serena J., Davalos A., Amarenco P., Evans S., Sprigg N., Dineen R., Eikelboom J. W., Chen C. aug 2019, In: Stroke. 50 , p. 2187-2196 10 p.

Histological differences of the Vascular wall between sites with high and low prevalence of intracranial aneurysm

Laarman Melanie D., Ruigrok Ynte M., Nierstrasz Renske C.S., Spliet Wim G.M., Van Hecke Wim, Algra Ale, Rinkel Gabriël J.E. 1 jul 2019, In: Journal of Neuropathology and Experimental Neurology. 78 , p. 648-654 7 p.

All Research Output (785)