title: Prior antiplatelet drug use and short-term mortality in older patients with acute ischemic stroke (AIS).
abstract: Some studies suggest that previous treatment with antiplatelet agents (AA) might reduce ischemic stroke severity and improve outcomes in terms of clinical deficits or mortality. We evaluated the effect of the prior chronic use of AA on short-term (30 days) mortality in a sample of consecutive patients with AIS. Four hundred thirty-nine older patients (>65 years) with "major" AIS (modified Rankin scale ≥ 3) consecutively admitted to the University ward of Internal Medicine or Geriatrics were enrolled. Stroke was classified according to Oxfordshire Community Stroke Project (OCSP). Data recorded included: (1) clinical features; (2) medical history including home therapies, and vascular risk factors; (3) routine clinical chemistry analyzes (verb)/analyses (noun). Short-term (30 days) mortality was 27.6%. One hundred fifteen subjects (26.2%) were taking AA before admission. Compared with subjects not treated, subjects taking AA were characterized by higher prevalence of recurrent stroke (35% vs. 22%). In this group, a trend toward a higher prevalence of congestive heart failure (CHF), smoking, and altered levels of consciousness (ALC) was noted. Stroke type and short-term mortality (33% vs. 26.2%; odds ratio=OR=1.25; 95% confidence interval=CI=0.75-2.10, age and gender adjusted) were not different between the two groups. Adjustment for glucose, CHF, previous stroke, smoking, and ALC did not change mortality risk (OR=0.83; 95%CI=0.40-1.72). We conclude that in older patients hospitalized for "major" AIS, prior use of AA was not associated with any benefit in terms of short-term mortality both in patients with first, as well as in those with recurrent ischemic stroke.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatrics, Arcispedale S. Anna, University of Ferrara, Via Savonarola 9, I-44100 Ferrara, Italy. gzuliani@hotmail.com
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zuliani
authors.forename: Matteo
authors.initials: M
authors.lastname: Galvani
authors.forename: Francesco
authors.initials: F
authors.lastname: Bonetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Prandini
authors.forename: Stefania
authors.initials: S
authors.lastname: Magon
authors.forename: Beatrice
authors.initials: B
authors.lastname: Gasperini
authors.forename: Carmelinda
authors.initials: C
authors.lastname: Ruggiero
authors.forename: Antonio
authors.initials: A
authors.lastname: Cherubini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy / Q000401:mortality
chemical_list: D010975:Platelet Aggregation Inhibitors