EAN 2021 | Future applications of precision medicine in stroke treatment

Ana Catarina Fonseca, MD, PhD, University of Lisbon, Lisbon, Portugal, discusses future applications of precision medicine in ischemic stroke. Neuroimaging techniques such as computed tomography (CT) perfusion and MRI have provided strong evidence to support precision medicine as a treatment for stroke. Precision medicine has also been used to help determine viable treatment options, such as clopidogrel, an antiplatelet treatment used to treat and prevent recurrence of ischemic strokes and transient ischemic attacks (TIAs). Through further studies, it’s been identified that some patients have a mutated version of the hepatic enzyme CYP2C19, involved in the liver metabolism of clopidogrel. Through identifying this, it can be understood which treatment is more suitable for the individual. This can be exemplified through the CHANCE-2 (NCT04078737) clinical trial, which has used genotyping before antiplatelet treatment. If results obtained from the study are positive, point of care testing devices could be used to treat patients. Precision medicine strategies for primary prevention and hemorrhagic stroke are also discussed. This interview took place during the European Academy of Neurology 2021 congress.