Genotype Guided Antiplatelet Therapy in Ischemic Stroke

Launched by NATIONAL NEUROSCIENCE INSTITUTE · Feb 28, 2023

Keywords

ClinConnect Summary

This clinical trial is studying how genetic testing can help improve treatment for patients who have had an ischemic stroke or a transient ischemic attack (TIA). It focuses on patients who are new to clopidogrel, a common medication used to prevent further strokes. The trial aims to see if checking for specific genetic markers can help doctors decide whether to continue with clopidogrel or switch to other medications, especially for those patients whose bodies may not respond well to clopidogrel due to genetic factors.

To be eligible for the trial, participants must be at least 21 years old and must have been diagnosed with an acute ischemic stroke or TIA within the last week. The study will involve drawing a blood sample to check for genetic mutations that affect how well clopidogrel works. Depending on the results, participants may either continue with clopidogrel or receive alternative treatments. Throughout the trial, patients will be monitored to see how well the chosen therapy works in preventing future strokes or other serious health events. This research is important because it could lead to more personalized and effective treatment options for stroke patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients diagnosed with acute ischemic stroke or transient ischemic attack.
• • Age 21 years to 100 years.
• • Can be randomised within 7 days of onset of index event \[Refer to footnote 1\].
• • Clopidogrel naive immediately prior to index event \[Refer to footnote 2\].
• • Footnote 1: Date of index event to be taken as Day 1. This means that randomisation must be done by Day 7. For unknown onset or wake-up stroke where the last seen well and symptoms discovery are on different days, Day 1 is taken to be the date of symptoms discovery. Footnote 2: Patients who were on short-term antiplatelets which included clopidogrel but are no longer on clopidogrel prior to stroke would fulfil for this inclusion criteria. In this context, short-term antiplatelets are defined as 21 days for minor stroke TIA and 3 months for large vessel disease.
• Exclusion Criteria:
• • Known diagnosis of dementia \[Refer to footnote 3\].
• • Known diagnosis of a life limiting illness with life expectancy of less than 1 year.
• • Known cardioembolism or prothrombotic state necessitating the use of anticoagulation, or having a contraindication to clopidogrel.
• • Footnote 3: "Known diagnosis of dementia" will be defined as clinical diagnosis of dementia prior to the index stroke event as indicated in the patient's medical records.