Abstract Number: Esoc2026a686 Assessment of Occurrence of Ischaemic Strokes on Clopidogrel and Need for Clopidogrel Resistance Testing in an NHS Hospital

Abstract Background and aims Clopidogrel 75mg is the standard antithrombotic therapy for treatment of non-cardioembolic acute stroke, transient ischemic attack (TIA), and intracranial atherosclerotic disease. For patients with recurrent TIA or stroke whilst taking clopidogrel, consideration should be given to clopidogrel resistance as recommended by National Clinical Guideline for Stroke for the UK and Ireland. In multiple studies, the pooled prevalence of clopidogrel resistance was 28%. We aimed to determine the incidence of strokes in patients on clopidogrel to consider the implications for resistance testing. Methods We performed retrospective data collection of 326 patients admitted to a tertiary NHS hospital with acute ischaemic stroke confirmed on CT/MRI. Patient on clopidogrel were recorded including their medications, risk factors and investigations. Results 49 patients (15%) presenting with acute ischaemic stroke were on clopidogrel, while 10 (3%) were on dual antiplatelets. Atrial fibrillation was found in 5 patients on clopidogrel (10%), while 2 patients had metastatic cancer. 85% of patients taking clopidogrel had previous stroke. Hypertension was the most common risk factor found in 81.6% of patients. Mean HBA1c and cholesterol were fairly within limits. Conclusions 12.8% of patients had stroke on clopidogrel and 3% on dual antiplatelets without an obvious cause. Screening for AF is crucial, but given the high percentage, testing for clopidogrel resistance should be considered for a more individualized treatment plan. Conflict of interest Mohamed Maged: nothing to disclose, Louisa Rowland: nothing to disclose, Richard Marigold: nothing to disclose, Charis Mavrokordatos: nothing to disclose, Ehsan Ul Haq: nothing to disclose, Shady Elsalhawy: nothing to disclose, Bouchra Lahmar: nothing to disclose