The prescribing patterns of antithrombotic agents for prevention of recurrent ischemic stroke.
OBJECTIVE
Antithrombotic agents are effective in the secondary prevention of ischemic strokes. In the present study, we sought to determine the antithrombotic prescribing patterns of neurologists in patients with first-ever ischemic stroke and also to identify the factors influencing the choice of a specific agent and what changes are made when a recurrent stroke occurs in these patients.


METHODS
We retrospectively reviewed the medical records of neurology patients who were diagnosed with first-ever ischemic stroke and were antithrombotic naive from January 1, 2000 to December 31, 2000. Patients' antithrombotic agents at discharge and during the follow-up period were reviewed to identify factors affecting the choice of antithrombotic agents.


RESULTS
A total of 376 patients experienced non-fatal first-ever ischemic stroke. Of these, 351 were prescribed antithrombotic agents at discharge, while the remaining 25 were not on antithrombotic treatment. Low-dose aspirin was the most commonly prescribed agent (65%). The most important determinant for the choice of other antiplatelet agents was aspirin intolerance. Not surprisingly, only 36% of the patients with atrial fibrillation were treated with oral anticoagulants at the time of hospital discharge.


CONCLUSIONS
Aspirin remains the most commonly used antithrombotic agent for the prevention of recurrent stroke among antithrombotic naive patients with a first-ever ischemic stroke in our institution. Our results demonstrate that current recommendations find their way into clinical practice, but to a limited extent. We aim that all patients discharged from our hospital after strokes must receive appropriate antithrombotic drugs for prevention of recurrent strokes provided if there are no contraindications to therapy.
Po
Helen L
HL
Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan. hlpyjl@ms1.mmh.org.tw
Lin
Ya-Ju
YJ
Hseuh
I-Hung
IH
D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D002545:Brain Ischemia / Q000517:prevention & control*; D004363:Drug Utilization; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D020521:Stroke / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D001241:Aspirin