title: Persistence of secondary prevention medications after acute ischemic stroke or transient ischemic attack in Chinese population: data from China National Stroke Registry.
abstract: OBJECTIVE
  Although proven stroke secondary prevention medications are available, persistent use is required to be effective. The present study aimed to investigate the degree of secondary prevention medications persistence after acute ischemic stroke (AIS) or transient ischemic  attack (TIA), factors influencing persistence and its association with stroke outcomes.
  
  
  METHODS
  We examined patients with AIS or TIA enrolled in China National Stroke Registry (CNSR) between 2007 and 2008. Three-month persistence was defined as medication continuation between hospital  discharge and 3-month postdischarge. Recurrent stroke and modified Rankin scale (mRS)≤2 at 3-month postdischarge were used as stroke outcomes. Logistic regression was used to adjust for confounders.
  
  
  RESULTS
  Totally, 9998 patients were analyzed. At 3 months, 63·6% of patients  continued taking all secondary prevention medications prescribed at hospital discharge. Younger age (P = 0·05), male gender (P = 0·03), present history of hypertension (P<0·001), absent history of atrial fibrillation (P<0·001),  pre-stroke independence (P = 0·05), index cerebrovascular event of AIS (P = 0·005), being treated in an academic hospital (P = 0·003), longer hospital stay (P<0·001), and fewer number of class of baseline  secondary prevention medications (P<0·001) were identified as determinants for 3-month persistence. 3-month persistence of secondary prevention medications were significantly associated with less recurrent stroke (adjusted OR = 0·78, 95% CI = 0·67-0·91,  P = 0·002) and better functional outcome (mRS≤2) (adjusted OR = 1·17, 95% CI = 1·04-1·32, P = 0·009) at 3-month postdischarge.
  
  
  CONCLUSIONS
  Almost one-third of patients of AIS/TIA had  stopped one or more secondary prevention medications by 3-month postdischarge. Further studies on identifying potential barriers and means to improve persistent use of secondary prevention interventions are needed.
authors: Tiantan Comprehensive Stroke Center, Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Ruijun
authors: R
authors: Ji
authors: Gaifen
authors: G
authors: Liu
authors: Haipeng
authors: H
authors: Shen
authors: Yilong
authors: Y
authors: Wang
authors: Hao
authors: H
authors: Li
authors: Eric
authors: E
authors: Peterson
authors: Yongjun
authors: Y
authors: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods* / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult