Abstract
Methods—Using data from Get With The Guidelines-Stroke with over half a million acute ischemic strokes recorded between October 2011 and March 2014 (n=540 993) from 1661 hospitals across the United States, we examined the unadjusted and adjusted associations between previous antithrombotic use and clinical outcomes.
Results—There were 250 104 (46%) stroke patients not receiving any antithrombotic before stroke; of whom approximately one third had a documented previous vascular indication. After controlling for clinical and hospital factors, patients who were receiving antithrombotics before stroke had better outcomes than those who did not, regardless of whether a previous vascular indication was present or not: adjusted odds ratio (95% confidence intervals) were 0.82 (0.80–0.84) for in-hospital mortality, 1.18 (1.16–1.19) for home as the discharge destination, 1.15 (1.13–1.16) for independent ambulatory status at discharge, and 1.15 (1.12–1.17) for discharge modified Rankin Scale score of 0 or 1.
Conclusions—Previous antithrombotic therapy was independently associated with improved clinical outcomes after acute ischemic stroke. Ensuring the use of antithrombotics in appropriate patient populations may be associated with benefits beyond stroke prevention.
| Original language | English |
|---|---|
| Pages (from-to) | 2066-2074 |
| Number of pages | 9 |
| Journal | Stroke |
| Volume | 47 |
| Issue number | 8 |
| Early online date | 19 Jul 2016 |
| DOIs | |
| Publication status | Published - 1 Aug 2016 |
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Keywords
- mortality
- prognosis
- stroke
- antiplatelet agents
- antithrombotic agents
Cite this
Prior Antithrombotic Use Is Associated With Favorable Mortality and Functional Outcomes in Acute Ischemic Stroke. / Myint, Phyo K. (Corresponding Author); Hellkamp, Anne S. ; Fonarow, Gregg C. ; Reeves, Matthew J.; Schwamm, Lee H.; Schulte, Phillip J.; Xian, Ying; Suter, Robert E.; Bhatt, Deepak L.; Saver, Jeffrey L.; Peterson, Eric D.; Smith, Eric E.
In: Stroke, Vol. 47, No. 8, 01.08.2016, p. 2066-2074.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prior Antithrombotic Use Is Associated With Favorable Mortality and Functional Outcomes in Acute Ischemic Stroke
AU - Myint, Phyo K.
AU - Hellkamp, Anne S.
AU - Fonarow, Gregg C.
AU - Reeves, Matthew J.
AU - Schwamm, Lee H.
AU - Schulte, Phillip J.
AU - Xian, Ying
AU - Suter, Robert E.
AU - Bhatt, Deepak L.
AU - Saver, Jeffrey L.
AU - Peterson, Eric D.
AU - Smith, Eric E.
N1 - Acknowledgments Drs Myint and Smith conceived the idea and developed the analysis plan with critical input from coauthors. A.S. Hellkamp analyzed the data. Drs Myint and Smith drafted the article with input from all coauthors. All authors contributed in interpretation of results and in making an important intellectual contribution to the article. Sources of Funding The Get With The Guidelines (GWTG)-Stroke program is currently supported, in part, by a charitable contribution from Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership and the American Heart Association Pharmaceutical Roundtable. GWTG-Stroke has been funded in the past through support from Boehringer-Ingelheim and Merck. These funding agencies did not participate in design or analysis, article preparation, or approval of this study.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background and Purpose—Antithrombotics are the mainstay of treatment in primary and secondary prevention of stroke, and their use before an acute event may be associated with better outcomes.Methods—Using data from Get With The Guidelines-Stroke with over half a million acute ischemic strokes recorded between October 2011 and March 2014 (n=540 993) from 1661 hospitals across the United States, we examined the unadjusted and adjusted associations between previous antithrombotic use and clinical outcomes.Results—There were 250 104 (46%) stroke patients not receiving any antithrombotic before stroke; of whom approximately one third had a documented previous vascular indication. After controlling for clinical and hospital factors, patients who were receiving antithrombotics before stroke had better outcomes than those who did not, regardless of whether a previous vascular indication was present or not: adjusted odds ratio (95% confidence intervals) were 0.82 (0.80–0.84) for in-hospital mortality, 1.18 (1.16–1.19) for home as the discharge destination, 1.15 (1.13–1.16) for independent ambulatory status at discharge, and 1.15 (1.12–1.17) for discharge modified Rankin Scale score of 0 or 1.Conclusions—Previous antithrombotic therapy was independently associated with improved clinical outcomes after acute ischemic stroke. Ensuring the use of antithrombotics in appropriate patient populations may be associated with benefits beyond stroke prevention.
AB - Background and Purpose—Antithrombotics are the mainstay of treatment in primary and secondary prevention of stroke, and their use before an acute event may be associated with better outcomes.Methods—Using data from Get With The Guidelines-Stroke with over half a million acute ischemic strokes recorded between October 2011 and March 2014 (n=540 993) from 1661 hospitals across the United States, we examined the unadjusted and adjusted associations between previous antithrombotic use and clinical outcomes.Results—There were 250 104 (46%) stroke patients not receiving any antithrombotic before stroke; of whom approximately one third had a documented previous vascular indication. After controlling for clinical and hospital factors, patients who were receiving antithrombotics before stroke had better outcomes than those who did not, regardless of whether a previous vascular indication was present or not: adjusted odds ratio (95% confidence intervals) were 0.82 (0.80–0.84) for in-hospital mortality, 1.18 (1.16–1.19) for home as the discharge destination, 1.15 (1.13–1.16) for independent ambulatory status at discharge, and 1.15 (1.12–1.17) for discharge modified Rankin Scale score of 0 or 1.Conclusions—Previous antithrombotic therapy was independently associated with improved clinical outcomes after acute ischemic stroke. Ensuring the use of antithrombotics in appropriate patient populations may be associated with benefits beyond stroke prevention.
KW - mortality
KW - prognosis
KW - stroke
KW - antiplatelet agents
KW - antithrombotic agents
U2 - 10.1161/STROKEAHA.115.012414
DO - 10.1161/STROKEAHA.115.012414
M3 - Article
VL - 47
SP - 2066
EP - 2074
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 8
ER -