BACKGROUND AND PURPOSE: We aimed to describe the uptake of proven secondary prevention strategies for ischemic stroke in urban China. METHODS: In a prospective, multicenter, hospital-based registry of 4782 cases of acute ischemic stroke in China during 2006, the use of secondary prevention regimens was evaluated before hospital discharge and 3 and 12 months after stroke. Logistic regression analysis was performed to determine associations between various baseline variables and in-hospital use of antihypertensive, antiplatelet, and lipid-lowering therapies, and to identify variables associated with their continuation at 12 months. RESULTS: In-hospital initiation of antihypertensive (63%), antiplatelet (81%), and lipid-lowering (31%) therapies was influenced favorably by previous use and comorbid cardiovascular risk factors and unfavorably by stroke severity. Antihypertensive use was well-maintained during follow-up, whereas use of antiplatelet and lipid-lowering therapy decreased (66% and 17%, respectively; P<0.001) by 12 months after stroke, with discontinuation related to patient and physician factors. INTERPRETATION: There was a high level of uptake of secondary prevention for ischemic stroke in this nationwide sample of hospitalized patients in urban China. However, use of antiplatelet and lipid-lowering therapy declined substantially after discharge, apparently related to misperceptions of subsequent disease risk by both doctors and patients.
AD - The George Institute for International Health, PO Box M201, Missenden Rd, Camperdown NSW 2050, Australia. jwei@george.org.au AN - 20224061 BT - Stroke ET - 2010/03/13 LA - eng M1 - 5 N1 - Wei, Jade WWang, Ji-GuangHuang, YiningLiu, MingWu, YangfengWong, Lawrence K SCheng, YanXu, EnYang, QidongArima, HisatomiHeeley, Emma LAnderson, Craig SChinaQUEST InvestigatorsComparative StudyMulticenter StudyResearch Support, Non-U.S. Gov'tUnited StatesStroke; a journal of cerebral circulationStroke. 2010 May;41(5):967-74. Epub 2010 Mar 11. N2 -BACKGROUND AND PURPOSE: We aimed to describe the uptake of proven secondary prevention strategies for ischemic stroke in urban China. METHODS: In a prospective, multicenter, hospital-based registry of 4782 cases of acute ischemic stroke in China during 2006, the use of secondary prevention regimens was evaluated before hospital discharge and 3 and 12 months after stroke. Logistic regression analysis was performed to determine associations between various baseline variables and in-hospital use of antihypertensive, antiplatelet, and lipid-lowering therapies, and to identify variables associated with their continuation at 12 months. RESULTS: In-hospital initiation of antihypertensive (63%), antiplatelet (81%), and lipid-lowering (31%) therapies was influenced favorably by previous use and comorbid cardiovascular risk factors and unfavorably by stroke severity. Antihypertensive use was well-maintained during follow-up, whereas use of antiplatelet and lipid-lowering therapy decreased (66% and 17%, respectively; P<0.001) by 12 months after stroke, with discontinuation related to patient and physician factors. INTERPRETATION: There was a high level of uptake of secondary prevention for ischemic stroke in this nationwide sample of hospitalized patients in urban China. However, use of antiplatelet and lipid-lowering therapy declined substantially after discharge, apparently related to misperceptions of subsequent disease risk by both doctors and patients.
PY - 2010 SN - 1524-4628 (Electronic)0039-2499 (Linking) SP - 967 EP - 74 T2 - Stroke TI - Secondary prevention of ischemic stroke in urban China VL - 41 ER -