title: Prestroke antiplatelet therapy and early prognosis in stroke patients: the Dijon Stroke Registry.
abstract: OBJECTIVE
  Previous antiplatelet therapy (APT) in cardiovascular prevention is common in patients with first-ever stroke. We aimed to evaluate the prognostic value of APT on early outcome in stroke patients.
  
  
  METHODS
  All first-ever strokes from 1985 to 2011 were identified from the population-based Stroke Registry of Dijon, France. Demographic features, risk factors, prestroke treatments and clinical information were recorded. Multivariate analyses were performed to evaluate the associations between pre-admission APT and both severe handicap at discharge, and mortality at 1 month and 1 year.
  
  
  RESULTS
  Among the 4275 patients, 870 (20.4%) were previously treated with APT. Severe handicap at discharge was noted in 233 (26.8%) APT users and in 974 (28.7%) non-users. Prestroke APT use was associated with lower odds of severe handicap at discharge [adjusted odds ratio (OR): 0.79; 95% confidence interval (CI): 063-1.00; P = 0.046], non-significant better survival at 1 month [adjusted hazard ratio (HR): 0.87; 95% CI: 0.70-1.09; P = 0.222] and no effect on 1-year mortality (HR: 0.94; 95% CI 0.80-1.10; P = 0.429). In stratum-specific analyses, APT was associated with a lower risk of 1-month mortality in patients with cardioembolic ischaemic stroke (HR: 0.65; 95% CI: 0.43-0.98; P = 0.040).
  
  
  CONCLUSIONS
  APT before stroke was associated with less severe handicap at discharge, with no significant protective effect for mortality at 1 month except in patients with cardioembolic stroke. No protective effect of APT was observed for mortality at 1 year. Further studies are needed to understand the mechanisms underlying the distinct effects of prior APT observed across the ischaemic stroke subtypes.
authors.affiliation: Dijon Stroke Registry, Department of Neurology, University Hospital and Medical School of Dijon, University of Burgundy, Dijon, France. ybejot@yahoo.fr
authors.forename: Y
authors.initials: Y
authors.lastname: Béjot
authors.forename: C
authors.initials: C
authors.lastname: Aboa-Eboulé
authors.forename: E
authors.initials: E
authors.lastname: de Maistre
authors.forename: A
authors.initials: A
authors.lastname: Jacquin
authors.forename: O
authors.initials: O
authors.lastname: Troisgros
authors.forename: M
authors.initials: M
authors.lastname: Hervieu
authors.forename: G V
authors.initials: GV
authors.lastname: Osseby
authors.forename: O
authors.initials: O
authors.lastname: Rouaud
authors.forename: M
authors.initials: M
authors.lastname: Giroud
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors