Abstract W P350: Pre-Stroke Antiplatelet Use and Outcomes in a Cohort of Ischemic Stroke Patients

Abstract

Background and purpose: previous studies had found that pre-stroke antiplatelet use reduces stroke severity. Our objective was to evaluate this issue in a cohort with good levels of pre-stroke vascular risk factors control. Methods: ischemic stroke patients were prospectively included in PROTEGE-ACV, a multidisciplinary prevention program. Demographic data, vascular risk factor profile and control before stroke were obtained from electronic records. Patients with functional impairment (Rankin ≥ 4), dementia or life expectancy less than three years were excluded. One month after discharge, the following tests were performed: MMSE adjusted by age and educational status, clock drawing test CDT (normal or abnormal), Barthel index, modified Rankin scale (≥3 functional impairment). Mortality and recurrence were evaluated after a mean follow-up of 2 years. Results: between December 2006 and April 2013, 1090 patients (55% female, mean age 75± 11 years) were included, 44% (n=472) were using antiplatelet drugs in the year before the stroke. This group had higher prevalence of major vascular risk factors (with good level of control in both groups) and burden of disease in other vascular beds. Stroke outcomes were worse in patients receiving antiplatelet drugs before stroke (Table). This lack of effect on functional outcomes persisted after a multivariate analysis including statins and antihpertensives. Conclusion: in contrast to published data, we did not found a beneficial effect of using of antiplatelet drugs before stroke on functionality and cognition, neither on recurrence and mortality prevention in our cohort.