A novel testing service to rapidly identify stroke patients not responding to Clopidogrel antithrombotic therapy, and switch them to alternative effective medication. (Platelet Solutions-RPFT).

血小板解决方案有限公司（PS有限公司）是一家微型中小企业，成立于诺丁汉大学心血管医学的广泛研究和经验。当大脑中的血液流动中断时，就会发生中风；要么是由于血栓，缺血性中风（IS），要么是动脉破裂（出血性中风）。在英国，每3分钟27秒就有一例中风发生在所有年龄段的人身上——英国每年有90.1万例缺血性中风，4.6万例短暂性脑缺血发作（tia或小中风，症状在24小时内消失）。2009年，中风护理的年度总费用估计为90亿英镑——占英国国民保健服务总费用的5%——直接护理费用为45亿英镑，非正式护理费用为24亿英镑，间接费用为21亿英镑。在第一次中风后的5年内，有大约25%的风险复发更衰弱的事件。为了降低再次中风的风险，所有IS和TIA后的患者都终身接受氯吡格雷抗血小板治疗。然而，并不是所有的患者都对药物治疗有反应，也没有进行测试来确定他们是否有更高的中风风险。我们已经开发了一种商业和技术创新的测试服务，以确定那些不能从氯吡格雷药物治疗中获益的患者，以及那些广泛可用的替代治疗（阿司匹林与双嘧达莫）将有益的患者。我们预计，全面采用这项服务可以为NHS每年节省高达3850万英镑的直接医疗费用，为英国经济每年节省7910万英镑的非正式护理和生产力损失。项目的成功将使血小板解决方案有限公司转型为中小企业。

PLATELET SOLUTIONS LTD (PS Ltd.) is a micro-SME founded on extensive research andexperience in Cardiovascular Medicine at Nottingham University. A stroke occurs whenblood flow in the brain is interrupted; either due to blood clots, ischaemic stroke (IS), or anartery bursts (haemorrhagic stroke). One occurs every 3 mins 27 s in the UK striking peopleof all ages - each year in the UK there are 90.1k ISs, and 46k transient ischaemic attacks(TIAs or mini-strokes, where symptoms resolve in 24 hrs). In 2009 the total annual costs ofstroke care were estimated at £9b - 5% of total UK NHS costs - direct care of £4.5b, informalcare £2.4b, and indirect costs of £2.1b. Within 5 years of the first stroke there is a ca. 25% riskof recurrence of a more debilitating event. To reduce the risk of another stroke all patientsafter IS and TIA receive antiplatelet treatment with clopidogrel for life. However, not allpatients respond to the drug therapy and no testing is performed to identify them placing thissub-group at higher risk of another stroke. We have developed a commercially and technologyinnovative testing service to identify patients who are not benefiting from clopidogrel drugtherapy and for whom widely available alternative therapy (aspirin with dipyridamole) wouldbe beneficial. We project that full uptake of the service could save the NHS up to £38.5m p.a.in direct medical costs, and the UK economy £79.1m p.a. in informal care and productivityloses. Success of the project will transform Platelet Solutions Ltd. to a SME.