Pioneering genetic test transforms stroke care
A pioneering genetic testing programme is set to transform stroke care across NHS Scotland by identifying the most effective treatment for each patient, improving outcomes and preventing future strokes.
Each year, around 13,000 cases of stroke and Transient Ischaemic Attacks (TIA) are recorded, with Clopidogrel the most commonly prescribed drug to reduce a patient’s risk of having a further stroke.
However, research shows that approximately 1 in 3 patients do not respond to this treatment due to common variants in their genes.
This groundbreaking test allows clinicians to quickly and effectively identify patients who have these variations in order to prescribe a more effective medication.
Pioneered by clinicians at NHS Tayside, the Pharmacogenetics Stroke Clopidogrel (CYP2C19) Genotype Testing Programme is being rolled out nationally from October 2025 beginning with NHS Grampian and NHS Western Isles, through the Accelerated National Innovation Adoption (ANIA) pathway, led by NHS Golden Jubilee’s national Centre for Sustainable Delivery (CfSD).
Consultant in Stroke/Acute Medicine and Clinical Lead for the project in NHS Grampian, Petrus Elofuke, commented: "Developing the healthcare solutions of the future is very much a team effort and we're pleased to be working with colleagues across NHS Tayside, NHS Western Isles and NHS Golden Jubilee.
“The adoption of genetic testing for patients at Western Isles Hospital, Dr Gray's Hospital in Elgin and Aberdeen Royal Infirmary will be of huge benefit to them and it's great to be part of helping Scotland take this step forward in delivering precision medicine."
David Baty, Consultant Clinical Scientist at NHS Tayside, said: “This is a very exciting development in stroke treatment for NHS Scotland, which will allow us to make sure that every patient receives the medication that works best for them as quickly as possible.
“Providing the right care, at the right time, gives people the best possible chance of recovery and regaining their independence. This also has the potential to reduce hospital stays, prevent future strokes and ultimately save lives.”
The new Pharmacogenetics Stroke Clopidogrel (CYP2C19) Genotype Testing programme allows clinicians to identify patients who are less responsive to Clopidogrel and provide them with a more effective alternative.
In collaboration with the University of Dundee, NHS Tayside carried out the UK’s first routine genotyping testing project for prescribing Clopidogrel in acute stroke patients.
More than 2,000 patients were tested, with almost a third found to be less responsive to Clopidogrel. Building on these foundations, the programme is expected to test 100,000 patients over the next 5 years, with around 30,000 benefiting from tailored medication.
It is also projected to prevent nearly 1,000 secondary strokes over the 5-year period, avoiding £17.9 million in healthcare costs, as well as £30.6 million in wider social care costs.
Health Secretary, Neil Gray said: “This is a perfect example of how an innovation developed in NHS Tayside will now benefit patients across Scotland through our Accelerated National Innovation Adoption pathway.
“This new test will enable clinicians to make more informed decisions and help to prevent further strokes.
“I look forward to seeing this rolled out across the country over the next 12 months.”
Katie Cuthbertson, National Director for CfSD, added “This work supports the strengthening of healthcare across Scotland by adopting effective new technologies quickly, easing pressure on services, and making the best use of NHS resources.
“By introducing this test nationally, Scotland is leading the way in precision medicine and showing a clear commitment to innovation that benefits patients, families, and the wider health system.”
This is the first national rollout of its kind in the UK for stroke care and represents a major step forward in precision medicine. It demonstrates NHS Scotland’s leadership in modern, personalised healthcare and commitment to innovation, sustainability and realistic medicine.
