title: Effect of prestroke antiplatelets use on first-ever ischaemic stroke severity and early outcome.
abstract: OBJECTIVE
  We aimed to investigate whether prior use of antiplatelet agents (AP) may be associated with lower severity and improved short-term outcome of the first-ever acute ischaemic stroke.
  
  
  METHODS
  This was a retrospective, case-control study based on a prospective hospital stroke registry covering consecutive acute stroke patients admitted to a single stroke centre in highly urbanised area (Warsaw, Poland) between 1995 and 2013. Patients receiving oral anticoagulants were excluded from the analysis. Statistical analysis included multiple regression and logistic regression adjusted for age, sex, hypertension, atrial fibrillation, congestive heart failure, diabetes, coronary heart disease and history of myocardial infarction.
  
  
  RESULTS
  During the study period, there were 3036 eligible patients, of whom 879 (29%) received AP before stroke onset. Patients from the AP group were older and more often burdened with stroke risk factors. There were no differences in baseline stroke severity, hospital mortality and proportion of patients alive and independent at discharge. However, AP turned out to be independently associated with lower NIHSS score on admission (β = -0.045, p = 0.008) and increased odds for being alive and independent at discharge (odds ratio 1.36, 95% CI: 1.13-1.67) and decreased odds for in-hospital mortality (odds ratio 0.77, 95% CI: 0.59-0.99).
  
  
  CONCLUSIONS
  Our findings provide further evidence supporting modest benefit of AP therapy on the course and outcome of first-ever ischaemic stroke. Further large studies are needed to confirm this effect.
authors.affiliation: 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: J P
authors.initials: JP
authors.lastname: Bembenek
authors.affiliation: Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Niewada
authors.affiliation: 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Karlinski
authors.affiliation: 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.|Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Czlonkowska
mesh_terms: D000284:Administration, Oral; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011044:Poland / Q000453:epidemiology; D012042:Registries; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors