For over twenty years, he has been addressing stroke treatment. Although medicine was not his dream career, he became captivated by technological advancements and the hope they give patients. One of the founders of the FNUSA-ICRC research centre and a renowned expert in stroke treatment, he helped promote thrombolysis in the Czech Republic and is currently leading a comprehensive project to improve stroke care. Also, he is the creator of the international REgistry of Stroke Care Quality (RES-Q). A publication which he co-authored has now been published in one of the most prestigious scientific journals – The New England Journal of Medicine.
Brno-based neurologist Robert Mikulík participated in a major global study on the pharmacological treatment of recurrent stroke involving more than 7 000 patients. Stroke is the second leading cause of death worldwide. Up to 17 million people worldwide suffer a stroke each year and one third of them die from the condition. In the Czech Republic, approximately 25 thousand people have a stroke each year. Another important fact is that, for stroke, there is a high risk of recurrence.
“Within five years after the first stroke, 20% of patients suffer a recurrence. Yet the risk of recurrent ischaemic stroke can be greatly reduced by various preventive measures, including pharmacological ones. And this was the aim of the study, in which we compared two types of drugs to prevent recurrent stroke,” explains Brno-based neurologist doc. MUDr. Robert Mikulík, Ph.D. Head of Stroke Research Group of the International Clinical Research Centre at St. Anne’s University Hospital (FNUSA-ICRC) and Head of the Complex Cerebrovascular Centre at St. Anne’s University Hospital.
In the study, which included 7 213 patients aged 50 years and older who have recently had an ischaemic stroke caused by cerebral arterial embolism (ischaemic strokes are caused by obstruction of a cerebral artery by a blood clot), experts compared the efficacy and safety of two drugs – rivaroxaban, which had not been used to prevent this type of stroke, and aspirin, which is a well-established drug used to prevent stroke. The research has shown that rivaroxaban reduces the risk of stroke recurrence after embolic stroke to the same extent as aspirin but is not more effective than aspirin as expected.
The results of this study, in which Robert Mikulík participated not only as a co-author but also as a member of the management board that developed the procedure for the study and managed its proper progress, were published at the end of May in one of the world’s most prestigious scientific journals – The New England Journal of Medicine and, at the same time, the study was presented at the European Stroke Organisation Conference in Gothenburg, Sweden. Thanks to its high Impact Factor (IF = 72.406), which represents the average number of citations of an average publication in a given scientific or professional journal, the New England Journal of Medicine is currently the second best scientific journal in the world. Also, it is one of the world’s oldest scientific journals – it has been published in the US since 1812 and its current publisher is the Massachusetts Medical Society.
Doc. MUDr. Robert Mikulík, Ph.D.
- Along with the generation of his colleagues, he pioneered the use of a newly-proven treatment of stroke called thrombolysis in the Czech Republic.
- He works towards continuous improvement of the quality of care; he leads a comprehensive project to improve stroke care in 23 countries of Eastern Europe and Central Asia (http://eso-stroke.org/eso-east/); under its leadership, the REgistry of Stroke Care Quality – RES-Q (qualityregistry.eu) is being created under the umbrella of the European Stroke Organisation and with the support of the World Stroke Organisation, which is already being used in nearly 500 hospitals in 45 countries.
- He focuses on managing the treatment of acute stroke in order to reduce the time between the patient’s arrival in hospital and administration of treatment. He has published several papers on this topic and is developing new tools and methods to improve logistics. One method is to train doctors and nurses to adopt new logistics through simulation training. Doc. Mikulík and his team have developed simulation scenarios and, in simulation courses (stroke-simulation.eu), he has trained about 600 doctors and nurses from the Czech and Slovak Republics, Ukraine, Poland, Russia, South Africa, the Middle East, the Philippines and Malaysia since 2016.
- In the long term, he is devoted to systematically educating the public about the symptoms of and proper response to stroke.
- In recognition of his long-term engagement in public awareness raising and education, he has been appointed to the World Stroke Organisation’s Board for the World Stroke Campaign.
- Last year, he received the Spirit of Excellence award for his long-term and successful engagement in the field of organising stroke care and treatment at the national and international levels.
The International Clinical Research Centre at St. Anne’s University Hospital Brno (FNUSA-ICRC) is a prestigious international project that was founded in the Czech Republic in 2011. Funded largely by national and international grants, the international centre focuses on research into heart and brain diseases in order to find new technologies, treatment procedures and methods and medicines for prevention, early diagnosis and individualised treatment. Currently, more than 300 researchers and doctors from the Czech Republic, the USA, Canada, Argentina and nearly 20 European Union currently participate in FNUSA-ICRC activities. In addition, FNUSA-ICRC collaborates on international research with scientists and academic institutions all over the world. For example, it collaborates with the University of California San Diego, University of South Florida, Mayo Clinic, the University of Medicine in Vienna, the Swedish Karolinska Institutet, or two Chinese university hospitals.