CYP2C19 genotype testing to guide clopidogrel use after ischaemic stroke or transient ischaemic attack

4 Implementation

The committee acknowledged that implementing laboratory-based testing for everyone who has a stroke or TIA could be done in a stepwise process. This would involve a gradual increase in numbers tested while capacity is established. Testing could be initially started in groups of people who could benefit most from it, because of higher risk of stroke recurrence, such as people with non‑minor stroke. Alternatively, point-of-care testing should be considered as an alternative if laboratory-based testing is not feasible at this scale, or while capacity for laboratory-based testing is increased. See section 3.21 for further discussion of these issues.

NICE intends to develop tools, in association with relevant stakeholders, to help organisations put this guidance into practice.