High prevalence of previous antiplatelet drug use in patients with new or recurrent ischemic stroke: Buffalo metropolitan area and Erie County stroke study.
OBJECTIVE
To determine the proportion of patients in a large metropolitan population who developed ischemic stroke despite having received antiplatelet drug therapy, and their associated characteristics and in-hospital outcomes.


METHODS
Retrospective, cross-sectional study.


METHODS
Eleven hospitals in western New York State.


METHODS
One thousand five hundred eighty-two patients with new or recurrent ischemic stroke who were admitted to one of the 11 study hospitals between January 1 and December 31, 2000, and for whom data were available regarding previous drug therapy.


RESULTS
The proportion of patients taking antiplatelet drugs before the onset of stroke was determined. Demographic and clinical characteristics, stroke subtypes, in-hospital bleeding complications, mortality, and discharge drugs were compared between patients with and those without previous antiplatelet drug use. Previous use of antiplatelet drugs was observed in 642 (41%) of the 1582 patients admitted with ischemic stroke. The antiplatelet drugs were aspirin alone (494 patients), clopidogrel alone (70), aspirin and clopidogrel (36), aspirin in combination with other antiplatelet drugs (20), and others (22). Patients with previous use of antiplatelet drugs were older and more likely to have hypertension, diabetes mellitus, hyperlipidemia, and a history of cardiovascular disease. The proportion of patients with large-vessel disease was greater among patients with previous use of antiplatelet drugs. Patients with previous use of antiplatelet drugs were more likely to be discharged with aspirin, clopidogrel, and an aspirin-dipyridamole combination.


CONCLUSIONS
The relatively high proportion of patients who developed ischemic stroke despite taking antiplatelet drugs observed in this regional hospital-based study mandates clinical trials specifically addressing therapeutic intervention for this group of patients.
Qureshi
Adnan I
AI
Zeenat Qureshi Stroke Research Center, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey 07103, USA. aiqureshi@hotmail.com
Kirmani
Jawad F
JF
Safdar
Adnan
A
Ahmed
Shafiuddin
S
Sayed
Muhammad A
MA
Pande
Ravi U
RU
Ferguson
Richard
R
Hershey
Linda A
LA
Qazi
Khalid J
KJ
D001241:Aspirin / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D000077144:Clopidogrel; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D006760:Hospitalization; D006801:Humans; D009518:New York / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin