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Specialists at London Bridge Hospital develop a new life saving blood test

05 January 2012

A team of specialists at London Bridge Hospital have become the first in the UK to offer a new test to identify patients at risk of complications following heart surgery.

More than 120,000 people undergo coronary artery procedures each year including heart surgery and angioplasty - where a tiny balloon is inserted into the blocked artery to clear it.

Following these and other cardiac procedures, it is vital patients take blood thinning drugs to prevent the formation of blood clots which can cause a heart attack or stroke.

Clopidogrel, also known as Plavix, is one of the most commonly prescribed clot-busting drugs.  However, to prevent blood clots forming, the drug has to be turned into its active form in the liver. 

Recent studies show about a third of patients have a genetic defect which prevents Clopidogrel from working properly, leaving them three to five times more likely to die from a stroke or heart attack within a year of surgery.

Now doctors and scientists at London Bridge Hospital have developed a new screening programme to identify those at risk.

This tests patients’ blood to make sure it is clotting properly, and screens for the genetic defect, using a swab from the inside of the cheek.   The tests involve using a new blood analysis (DNA) machine costing just a £100 together with existing blood test technology. combined results are available in less than an hour and, if a problem is found, patients are put on alternative medication.

Alan Rayner, Chief Perfusionist, who developed the programme alongside consultant cardiologist Dr Cliff Bucknall, says routinely screening all patients requiring coronary intervention will save lives.

“Until now, patients have been given Clopidogrel with no monitoring of its effect. It’s been a one size fits all approach,” he says.  “In many cases, the first time doctors are aware it is not working properly is when a patient gets symptoms such as chest pain. For some, waiting until then may be too late.

“By screening all patients before, during and after heart surgery or intervention, we can provide more individualised care and ensure they are on the right medication right from the start,” said Mr Rayner.

Consultant cardiologist, Dr Cliff Bucknell said the new test regime was a big step forward in identifying patients who may be at risk and it is therefore, increasing patient safety.  “This is a very exciting development.  What we do here is to provide individual treatment to match each person’s need.   Here at London Bridge this is very important because we are trying to provide world class service.   World class care demands individualised treatment for our patients.” he said.

These tests are not routinely offered to heart surgery patients across the country and, in other hospitals, the results can take weeks because the blood samples have to be sent away to specialist laboratories for analysis.

Eventually it is hoped the new tests can be used for patients undergoing any form of major surgery including those who need surgery to remove tumours.  Research carried out in New Zealand found preventing just two heart attacks, would more than pay for 100 patients to be screened.