Changes in antiplatelet use prior to incident ischaemic stroke over 7 years in a UK centre and the association with stroke subtype

James R White, Joao H Bettencourt-Silva, John F Potter, Yoon K Loke, Phyo Kyaw Myint

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: guidelines have changed in relation to the indication of antiplatelet therapy for the primary and secondary prevention of stroke. Of interest is how the proportion of patients who had or had not taken antiplatelet agents prior to an incident stroke has changed over time, whether the type of antiplatelet agents used has altered and whether prior antiplatelet use is associated with a particular ischaemic stroke subtype.

Methods: a stroke register was retrospectively examined. All ischaemic stroke patients admitted between January 2004 and March 2011 to a single University Hospital with a catchment population of ∼750,000 were included. We excluded those who were on anticoagulants prior to the ischaemic stroke.

Results: a total of 4,307 ischaemic stroke patients [male 47.5%, mean age 77.6 (SD 11.7) years] were included. Of them, 54.7% (SD 2.2%) were not on any antiplatelet therapy prior to their incident stroke. The type and pattern of antiplatelet use prior to stroke did not change significantly during the 7-year study period, and there were no statistically significant differences between different ischaemic stroke subtypes with regards to prior antiplatelet use.

Conclusions: our findings highlight the requirement to improve currently available risk prediction scores as well as the potential clinical impact of antiplatelet resistance within the at risk population who are already on antiplatelets. These findings also indicate that targeting of multiple risk factors may be very important in stroke prevention.
Original languageEnglish
Pages (from-to)594-598
Number of pages5
JournalAge and Ageing
Volume42
Issue number5
Early online date5 Jul 2013
DOIs
Publication statusPublished - Sep 2013

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Stroke
Platelet Aggregation Inhibitors
Primary Prevention
Secondary Prevention
Anticoagulants
Guidelines
Therapeutics
Population

Keywords

  • antiplatelets
  • stroke
  • prevention
  • older people

Cite this

Changes in antiplatelet use prior to incident ischaemic stroke over 7 years in a UK centre and the association with stroke subtype. / White, James R; Bettencourt-Silva, Joao H; Potter, John F; Loke, Yoon K; Myint, Phyo Kyaw.

In: Age and Ageing, Vol. 42, No. 5, 09.2013, p. 594-598.

Research output: Contribution to journalArticle

White, James R ; Bettencourt-Silva, Joao H ; Potter, John F ; Loke, Yoon K ; Myint, Phyo Kyaw. / Changes in antiplatelet use prior to incident ischaemic stroke over 7 years in a UK centre and the association with stroke subtype. In: Age and Ageing. 2013 ; Vol. 42, No. 5. pp. 594-598.
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AB - Background: guidelines have changed in relation to the indication of antiplatelet therapy for the primary and secondary prevention of stroke. Of interest is how the proportion of patients who had or had not taken antiplatelet agents prior to an incident stroke has changed over time, whether the type of antiplatelet agents used has altered and whether prior antiplatelet use is associated with a particular ischaemic stroke subtype.Methods: a stroke register was retrospectively examined. All ischaemic stroke patients admitted between January 2004 and March 2011 to a single University Hospital with a catchment population of ∼750,000 were included. We excluded those who were on anticoagulants prior to the ischaemic stroke.Results: a total of 4,307 ischaemic stroke patients [male 47.5%, mean age 77.6 (SD 11.7) years] were included. Of them, 54.7% (SD 2.2%) were not on any antiplatelet therapy prior to their incident stroke. The type and pattern of antiplatelet use prior to stroke did not change significantly during the 7-year study period, and there were no statistically significant differences between different ischaemic stroke subtypes with regards to prior antiplatelet use.Conclusions: our findings highlight the requirement to improve currently available risk prediction scores as well as the potential clinical impact of antiplatelet resistance within the at risk population who are already on antiplatelets. These findings also indicate that targeting of multiple risk factors may be very important in stroke prevention.

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