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 (805)

Is Blood Pressure Lowering in the Very Elderly With Previous Stroke Associated With a Higher Risk of Adverse Events?

Tharmaratnam Damien, Karayiannis Christopher C, Collyer Taya A, Arima Hisatomi, McClure Leslie A, Chalmers John, Anderson Craig S, Benavente Oscar R, White Carole L, Algra Ale, Moran Chris, Phan Thanh G, Wang Wei C, Srikanth Velandai, 16 Dec 2021, In: Journal of the American Heart Association. 10

Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials

Woodhouse Lisa J, Montgomery Alan A, Mant Jonathan, Davis Barry R, Algra Ale, Mas Jean-Louis, Staessen Jan A, Thijs Lutgarde, Tonkin Andrew, Kirby Adrienne, Pocock Stuart J, Chalmers John, Hankey Graeme J, Spence J David, Sandercock Peter, Diener Hans-Christoph, Uchiyama Shinichiro, Sprigg Nikola, Bath Philip M Dec 2021, In: BMC Medical Research Methodology. 21

Apixaban versus no anticoagulation after anticoagulation-associated intracerebral haemorrhage in patients with atrial fibrillation in the Netherlands (APACHE-AF):a randomised, open-label, phase 2 trial

Schreuder Floris H B M, van Nieuwenhuizen Koen M, Hofmeijer Jeannette, Vermeer Sarah E, Kerkhoff Henk, Zock Elles, Luijckx Gert-Jan, Messchendorp Gert P, van Tuijl Julia, Bienfait H Paul, Booij Suzanne J, van den Wijngaard Ido R, Remmers Michel J M, Schreuder Antonia H C M L, Dippel Diederik W, Staals Julie, Brouwers Paul J A M, Wermer Marieke J H, Coutinho Jonathan M, Kwa Vincent I H, van Gelder Isabelle C, Schutgens Roger E G, Zweedijk Berber, Algra Ale, van Dalen Jan Willem, Jaap Kappelle L, Rinkel Gabriel J E, van der Worp H Bart, Klijn Catharina J M, Nov 2021, In: The Lancet. Neurology. 20 , p. 907-916 10 p.

Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death:an individual participant-level data meta-analysis

Rahimi Kazem, Bidel Zeinab, Nazarzadeh Milad, Copland Emma, Canoy Dexter, Wamil Malgorzata, Majert Jeannette, McManus Richard, Adler Amanda, Agodoa Larry, Algra Ale, Asselbergs Folkert W., Beckett Nigel S., Berge Eivind, Black Henry, Boersma Eric, Brouwers Frank P.J., Brown Morris, Brugts Jasper J., Bulpitt Christopher J., Byington Robert P., Cushman William C., Cutler Jeffrey, Devereaux Richard B., Dwyer Jamie P., Estacio Ray, Fagard Robert, Fox Kim, Fukui Tsuguya, Gupta Ajay K., Holman Rury R., Imai Yutaka, Ishii Masao, Julius Stevo, Kanno Yoshihiko, Kjeldsen Sverre E., Kostis John, Kuramoto Kizuku, Lanke Jan, Lewis Edmund, Lewis Julia B., Lievre Michel, Lindholm Lars H., Lueders Stephan, MacMahon Stephen, Mancia Giuseppe, Matsuzaki Masunori, Mehlum Maria H., Nissen Steven, Ogawa Hiroshi, 18 Sep 2021, In: The Lancet. 398 , p. 1053-1064 12 p.

Trial of endovascular treatment of Basilar-Artery occlusion

Puetz Volker, Algra Ale, Schonewille Wouter J 2 Sep 2021, In: The New England journal of medicine. 385 , p. 958-958 1 p.

Author Response: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 25 May 2021, In: Neurology. 96 , p. 1011-1011 1 p.

Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion

Langezaal Lucianne C M, van der Hoeven Erik J R J, Mont'Alverne Francisco J A, de Carvalho João J F, Lima Fabrício O, Dippel Diederik W J, van der Lugt Aad, Lo Rob T H, Boiten Jelis, Lycklama À Nijeholt Geert J, Staals Julie, van Zwam Wim H, Nederkoorn Paul J, Majoie Charles B L M, Gerber Johannes C, Mazighi Mikael, Piotin Michel, Zini Andrea, Vallone Stefano, Hofmeijer Jeannette, Martins Sheila O, Nolte Christian H, Szabo Kristina, Dias Francisco A, Abud Daniel G, Wermer Marieke J H, Remmers Michel J M, Schneider Hauke, Rueckert Christina M, de Laat Karlijn F, Yoo Albert J, van Doormaal Pieter-Jan, van Es Adriaan C G M, Emmer Bart J, Michel Patrik, Puetz Volker, Audebert Heinrich J, Pontes-Neto Octavio M, Vos Jan-Albert, Kappelle L Jaap, Algra Ale, Schonewille Wouter J, 20 May 2021, In: The New England journal of medicine. 384 , p. 1910-1920 11 p.

Risk of Stroke before Revascularisation in Patients with Symptomatic Carotid Stenosis: A Pooled Analysis of Randomised Controlled Trials:A Pooled Analysis of Randomised Controlled Trials

Fisch Urs, von Felten Stefanie, Wiencierz Andrea, Jansen Olav, Howard George, Hendrikse Jeroen, Halliday Alison, Fraedrich Gustav, Eckstein Hans-Henning, Calvet David, Bulbulia Richard, Becquemin Jean-Pierre, Algra Ale, Rothwell Peter, Ringleb Peter, Mas Jean-Louis, Brown Martin M, Brott Thomas G, Bonati Leo H, 5 Apr 2021, In: European Journal of Vascular and Endovascular Surgery. 61 , p. 881-887 7 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.

All research output

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