Stroke and transient ischaemic attack in over 16s: diagnosis and initial management

In March 2026, we reviewed these 3 NICE guidelines in relation to the use of genetic testing for clopidogrel.

Surveillance decision

We will not update the recommendations in the NICE guidelines that recommend the use of clopidogrel or antiplatelets. The evidence currently available is not considered significant enough to impact on NICE's guidelines on acute coronary syndromes and peripheral arterial disease.

For NICE's guideline on stroke, the position in the treatment pathway, that genotype testing has been assessed in NICE's HealthTech guidance on CYP2C19 genotype testing to guide clopidogrel use after ischaemic stroke or transient ischaemic attack, is outside of the scope of other NICE guidance. This could be considered for inclusion in the National Clinical Guideline for Stroke.