open access

Vol 47, No 6 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2013-02-25
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Pharmacotherapy prior to and in acute ischaemic stroke. The use of pharmacotherapy and drugs-associated outcomes in real-world practice – findings from the Polish Hospital Stroke Registry

Maciej Niewada, Iwona Marta Sarzyńska-Długosz, Marta Skowrońska, Bogumił Kamiński, Adam Kobayashi, Anna Członkowska
DOI: 10.5114/ninp.2013.39067
·
Neurol Neurochir Pol 2013;47(6):509-516.

open access

Vol 47, No 6 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2013-02-25

Abstract

Background and purpose

Stroke is a preventable disease and acute ischaemic stroke can be effectively treated. Specific pharmacotherapy is recommended in either prevention or acute ischemic stroke treatment. We aimed to evaluate the use and the early and late outcomes impact of drugs administered before and in acute ischaemic stroke in a real world practice.

Material and methods

Ischaemic stroke patients hospitalized between 1st March 2007 and 29th February 2008 and reported in Polish Hospital Stroke Registry were analysed. Fully anonymous data were collected with standardized, web-based questionnaire with authorized access. Multivariate regression models were used to adjust for case-mix and evaluate the impact of drugs used prior to or in acute ischaemic stroke on outcomes. The early outcomes were defined as in-hospital mortality or poor outcome (death or dependency – modified Rankin Scale ≥ 3) at hospital discharge, while late outcomes covered one-year survival.

Results

A total number of 26 153 ischaemic stroke patients (mean age: 71.8 years; females: 51.6%) was reported. The analysis of pharmacotherapy showed that preventive use of hypotensive agents, anticoagulants in atrial fibrillation, antiplatelets and statins is inadequate. Regression models confirmed some expected drug benefits and additionally revealed that antihypertensive drugs or aspirin used prior to stroke and oral anticoagulants or statins used in hospital were associated with better stroke outcome.

Conclusions

The prevention of ischaemic stroke needs to be monitored and improved. Evidence-based treatment of acute ischaemic stroke requires further promotion. The benefits of acute ischaemic stroke treatment with statins require to be confirmed in randomized controlled settings.

Abstract

Background and purpose

Stroke is a preventable disease and acute ischaemic stroke can be effectively treated. Specific pharmacotherapy is recommended in either prevention or acute ischemic stroke treatment. We aimed to evaluate the use and the early and late outcomes impact of drugs administered before and in acute ischaemic stroke in a real world practice.

Material and methods

Ischaemic stroke patients hospitalized between 1st March 2007 and 29th February 2008 and reported in Polish Hospital Stroke Registry were analysed. Fully anonymous data were collected with standardized, web-based questionnaire with authorized access. Multivariate regression models were used to adjust for case-mix and evaluate the impact of drugs used prior to or in acute ischaemic stroke on outcomes. The early outcomes were defined as in-hospital mortality or poor outcome (death or dependency – modified Rankin Scale ≥ 3) at hospital discharge, while late outcomes covered one-year survival.

Results

A total number of 26 153 ischaemic stroke patients (mean age: 71.8 years; females: 51.6%) was reported. The analysis of pharmacotherapy showed that preventive use of hypotensive agents, anticoagulants in atrial fibrillation, antiplatelets and statins is inadequate. Regression models confirmed some expected drug benefits and additionally revealed that antihypertensive drugs or aspirin used prior to stroke and oral anticoagulants or statins used in hospital were associated with better stroke outcome.

Conclusions

The prevention of ischaemic stroke needs to be monitored and improved. Evidence-based treatment of acute ischaemic stroke requires further promotion. The benefits of acute ischaemic stroke treatment with statins require to be confirmed in randomized controlled settings.

Get Citation

Keywords

ischaemic stroke, pharmacotherapy aspirin, oral anticoagulants, antihypertensives, statins

About this article
Title

Pharmacotherapy prior to and in acute ischaemic stroke. The use of pharmacotherapy and drugs-associated outcomes in real-world practice – findings from the Polish Hospital Stroke Registry

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 47, No 6 (2013)

Pages

509-516

DOI

10.5114/ninp.2013.39067

Bibliographic record

Neurol Neurochir Pol 2013;47(6):509-516.

Keywords

ischaemic stroke
pharmacotherapy aspirin
oral anticoagulants
antihypertensives
statins

Authors

Maciej Niewada
Iwona Marta Sarzyńska-Długosz
Marta Skowrońska
Bogumił Kamiński
Adam Kobayashi
Anna Członkowska

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