title: Changes in antiplatelet use prior to incident ischaemic stroke over 7 years in a UK centre and the association with stroke subtype.
abstract: BACKGROUND
  guidelines have changed in relation to the indication of antiplatelet therapy for the primary and secondary prevention of stroke. Of interest is how the proportion of patients who had or had not taken antiplatelet agents prior to an incident stroke has changed over time, whether the type of antiplatelet agents used has altered and whether prior antiplatelet use is associated with a particular ischaemic stroke subtype.
  
  
  METHODS
  a stroke register was retrospectively examined. All ischaemic stroke patients admitted between January 2004 and March 2011 to a single University Hospital with a catchment population of ∼750,000 were included. We excluded those who were on anticoagulants prior to the ischaemic stroke.
  
  
  RESULTS
  a total of 4,307 ischaemic stroke patients [male 47.5%, mean age 77.6 (SD 11.7) years] were included. Of them, 54.7% (SD 2.2%) were not on any antiplatelet therapy prior to their incident stroke. The type and pattern of antiplatelet use prior to stroke did not change significantly during the 7-year study period, and there were no statistically significant differences between different ischaemic stroke subtypes with regards to prior antiplatelet use.
  
  
  CONCLUSIONS
  our findings highlight the requirement to improve currently available risk prediction scores as well as the potential clinical impact of antiplatelet resistance within the at risk population who are already on antiplatelets. These findings also indicate that targeting of multiple risk factors may be very important in stroke prevention.
authors.affiliation: Norwich Research Park Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, UK.
authors.forename: James R
authors.initials: JR
authors.lastname: White
authors.forename: Joao H
authors.initials: JH
authors.lastname: Bettencourt-Silva
authors.forename: John F
authors.initials: JF
authors.lastname: Potter
authors.forename: Yoon K
authors.initials: YK
authors.lastname: Loke
authors.forename: Phyo Kyaw
authors.initials: PK
authors.lastname: Myint
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D004351:Drug Resistance; D017723:Drug Utilization Review / Q000639:trends; D004739:England / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence / Q000639:trends; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011322:Primary Prevention / Q000639:trends*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000639:trends*; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: antiplatelets; older people; prevention; stroke