Grant for research into platelet inhibitors after stroke at young age Is lifelong use of medication necessary after TIA or ischemic stroke?

People who experienced a TIA or ischemic stroke at young age often have to use platelet inhibitors for their entire lives, while it has never been investigated whether any advantages of platelet inhibitors outweigh the higher risk of bleedings. Researchers of Radboud university medical center start a study to investigate this and receive a ZonMw-grant of 1.9 million euros.

Every year in the Netherlands, about 30,000 people suffer an ischemic stroke and over 50,000 suffer a TIA. Of these people, about ten percent are young. That is, they are between the ages of 18 and 49 at the time they experience an ischemic stroke or TIA. After this, they often use platelet inhibitors for their entire lives. The main disadvantage of platelet inhibitors is that they can cause bleedings. For young patients, it has never been investigated whether lifetime use of platelet inhibitors provides benefits, and whether these benefits outweigh the risks.

Neurologists Frank-Erik de Leeuw and Edo Richard and neurology resident Nina Hilkens are now starting a study in 28 centers in the Netherlands in which they are investigating whether lifelong use of these platelet inhibitors is necessary after an ischemic stroke or TIA without a known cause. Patients can participate in the study if they experienced an ischemic stroke or TIA without a known cause between three and ten years ago.  

De Leeuw: ‘In this study patients will be randomly divided in two groups. One group will stop using platelet inhibitors, the other group will continue the use of platelet inhibitors. Participants will be followed for five years. We will compare the occurrence of cardiovascular disease and bleeding between both groups and assess quality of life.’ We expect that the risk of cardiovascular disease is similar in both groups, while patients who stop platelet inhibitors experience less bleedings.

De Leeuw and Richard, both professors in Neurology, received a grant from ZonMw for this extensive research within the Rational Pharmacotherapy program, worth 1.9 million euros.