ABSTRACT
Background and Objectives: Stroke is the most common neurological disease in China and regulation of lipid levels is important for secondary prevention. This study aimed to investigate the practice of lipid lowering agents immediately after and one month following ischemic stroke in China, and to determine the factors affecting the practice. Methods: A total of 857 patients with acute ischemic stroke were enrolled from 11 hospitals in the Qingdao area, Northern China. Data pertaining to the patients’ demographic, clinical data, and treatment before and after the stroke were recorded. Univariate and multivariate logistic regression analyses were used to determine the factors associated with the treatment at two time points: at the acute stage and at one month follow-up. Results: The frequency of lipid lowering therapy was 50.3% (431/857) at acute stage and 41.5% (306/738) at one month. Lipid lowering therapy at acute stage was independently and positively associated with a history of hyperlipidemia((P=0.002, OR (95%CI): 3.784 (1.610-8.898)) and excess alcohol consumption (P=0.005, OR (95%CI): 1.928 (1.214-3.062)), partial anterior circulation infarct classifi cation (P=0.000, OR (95%CI): 1.974 (1.370-2.767)), and low-density lipoprotein levels ((P=0.000, OR (95%CI): 1.426 (1.170-1.739)). Lipid lowering therapy at one month follow-up was independently and positively associated with lipid lowering therapy at acute stage ((P=0.000, OR (95%CI): 18.275 (11.476- 29.101)), and negatively with the Modifi ed Rankin Scale ≥4 at follow-up ((P=0.030, OR (95%CI): 0.568 (0.341-0.948)). Conclusions: Lipid lowering therapy was found to be used in about half of patients during acute and early secondary prevention of ischemic stroke in the Qingdao area of Northern China. There should be more education efforts to the health care professionals and public to increase its use.
ABSTRACT
<p><b>BACKGROUND</b>Stroke is the most common neurological disease in China, and antiplatelet treatment is important for primary and secondary prevention. This study aimed to describe the current status of antiplatelet treatment before, immediately after, and 1 month after ischemic stroke in the Qingdao area of China, and to determine the factors and potential barriers influencing use.</p><p><b>METHODS</b>A total of 1114 patients with acute ischemic stroke were enrolled from 11 hospitals in the Qingdao area. Patient demographic data, clinical data, and treatment before and after the stroke were recorded. Univariate analysis (two sample t-test or Mann-Whitney U test, and chi-square test) and multivariate Logistic regression analysis were used to determine the frequency of antiplatelet treatment, and factors associated with treatment, at three time points: before the stroke, in hospital after the stroke, and at 1-month follow-up.</p><p><b>RESULTS</b>The frequency of antiplatelet treatment was 6.4% before the stroke, 91.5% in hospital, and 77.2% at 1 month. Aspirin pretreatment was independently associated with higher education level, higher income level, history of hyperlipidemia, and history of cerebral vascular disease. Antiplatelet treatment in hospital was independently associated with treatment in an urban hospital, National Institutes of Health Stroke Scale at onset, and statin use in hospital. Antiplatelet treatment at 1-month follow-up was independently associated with higher income level, diagnosis of transient ischemic attack, antiplatelet treatment in hospital, large artery atherosclerosis according to the Trial of Org 10172 in Acute Stroke Treatment classification, and statin use at follow-up. Modified Rankin Scale ≥ 4 at 1-month follow-up and history of coronary heart disease were negatively associated with antiplatelet treatment at follow-up.</p><p><b>CONCLUSIONS</b>This study documents the current status of antiplatelet treatment in primary and early secondary prevention of ischemic stroke in China. Further education of clinicians and the public about stroke prevention is important.</p>