Key messages

1. People who have an ischaemic stroke or TIA are often prescribed the antiplatelet medication clopidogrel to reduce their risk of another stroke. Some people are clopidogrel resistant and remain at risk of having another ischaemic stroke while taking clopidogrel.
2. Clopidogrel resistance can be caused by changes in the CYP2C19 gene. Genotype-guided antiplatelet therapy can potentially reduce the risk of stroke recurrence in people who are clopidogrel resistant and have had an ischaemic stroke or TIA.
3. People who are clopidogrel resistant should be prescribed an alternative antiplatelet.
4. Our cost analysis for NHSScotland found that the introduction of laboratory-based genotype-guided antiplatelet therapy for people who have had an ischaemic stroke or TIA led to estimated resource savings of £17.9 million over 5 years, based on 943 fewer people having a recurrent stroke.

Referred by 

The Accelerated National Innovation Adoption (ANIA) collaborative