Research from the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) may have discovered a new way to prevent strokes in high risk patients.
The findings of a new research group, led by Professor Donald Singer, Professor of Therapeutics at Warwick Medical School and Professor Chris Imray from UHCW have 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 often form on diseased carotid arteries in the neck. If small parts of these clots, called microemboli, break off they can travel to block key arteries in the brain arteries. This leads 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 these harmful microemboli.
Ultrasound scanning can be used to find patients who are at very high risk of stroke because microemboli have formed despite prior anti-platelet drugs. Using scanning, the team has found that an alternative anti-platelet drug designed to inhibit the formation of blood clots, called tirofiban, can suppress microemboli where previous treatment such as aspirin has been ineffective.
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.”
