Scientists may have discovered a new way to prevent strokes in high risk patients, according to research from the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW).
Work by a new research group, led by Professor Donald Singer, Professor of Therapeutics at Warwick Medical School and Professor Chris Imray from UHCW, has now been published in US journal Stroke.
The group is using ultrasound scanning to look at patients with carotid artery disease, one of the major causes of stroke. Clots can form on diseased carotid arteries in the neck. Small parts of these clots can released to form microemboli, which can travel to block key brain arteries and lead to weakness, disturbed speech, loss of vision and other serious stroke syndromes. Standard anti-platelet drugs such as aspirin may not prevent the formation of harmful microemboli.
The scanning process can be used to find patients at very high risk of stroke because microemboli have formed despite prior anti-platelet drugs. Using scanning, the team has found that tirofiban, another anti-platelet drug designed to inhibit the formation of blood clots, can suppress microemboli where previous treatment such as aspirin has been ineffective. In their study, tirofiban was more effective than other 'rescue' treatment.
Professor Singer said: "These findings show that the choice of rescue medicine is very important when carotid patients develop microemboli despite previous treatment with powerful anti-platelet drugs such as aspirin. We now need to go on to further studies of anti-microemboli rescue treatments, to aim for the right balance between protection and risk for our patients."
Professor Imray said: "These findings show the importance of ultrasound testing for micro-emboli in carotid disease patients. These biomarkers of high stroke risk cannot be predicted just from assessing the severity of risk factors such as smoking history, cholesterol and blood pressure."
- M. Saedon, D. R. J. Singer, R. Pang, C. Tiivas, C. E. Hutchinson, C. H. E. Imray. Registry Report on Kinetics of Rescue Antiplatelet Treatment to Abolish Cerebral Microemboli After Carotid Endarterectomy. Stroke, 2012; DOI: 10.1161/STROKEAHA.112.676338
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