title: Antiplatelet therapy in diabetic ischemic stroke patients: associated factors and outcomes.
abstract: BACKGROUND
  Patients with diabetes mellitus (DM) are more prone to develop atherosclerotic complications including stroke. Moreover, as a primary and secondary prevention of stroke, antiplatelet therapy is recommended by clinical guidelines for patients with DM.
  
  
  OBJECTIVE
  This study aimed to determine the prevalence of antiplatelet therapy use prior to current stroke in diabetic ischemic stroke patients, to examine the factors associated with the use of this important therapy and to assess the impact of the previous use of antiplatelet therapy on ischemic stroke outcomes.
  
  
  METHODS
  An observational study of diabetic acute ischemic stroke patients attending a Malaysian hospital during a 1-year period was carried out. Demographic information, risk factors, previous antiplatelet use and variables used to assess stroke outcomes were collected from medical records.
  
  
  RESULTS
  Overall, 295 diabetic stroke patients were analyzed. The prevalence of previous antiplatelet use among diabetic patients was 38.3%. The independent variables associated with the previous use of antiplatelet medication were previous stroke attack (p < 0.001) and ischemic heart disease (p < 0.001). Better outcomes as measured by a minor Glasgow Coma Scale at admission (p = 0.032), and a higher Modified Barthel index at discharge (p = 0.027) were observed among patients on previous antiplatelet therapy.
  
  
  CONCLUSIONS
  Our data suggest that antiplatelet therapy is under prescribed among such diabetic stroke patients, particularly in primary prevention. Effective methods to increase antiplatelet use and to enhance the adherence of clinical practice guidelines should be considered at the national and community level.
authors.affiliation: Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Malaysia. dryahaya2909@puncakalam.utim.edu.my
authors.forename: Y
authors.initials: Y
authors.lastname: Hassan
authors.forename: S W
authors.initials: SW
authors.lastname: Al-Jabi
authors.forename: N Abd
authors.initials: NA
authors.lastname: Aziz
authors.forename: I
authors.initials: I
authors.lastname: Looi
authors.forename: S H
authors.initials: SH
authors.lastname: Zyoud
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors