Secondary Stroke Prevention in Polish Adults: Results from the LIPIDOGRAM2015 Study.

Beata Łabuz-Roszak ,George Howard,Bryan Williams,Tomasz Tomasik,Fadi J Charchar,Adam Windak,Naveed Sattar,Dimitri P Mikhailidis,Kausik K Ray,Maciej Banach,Maciej Tomaszewski,Gregory Y.h Lip ,Mirosław Mastej ,Peter P Tóth ,Peter E Penson ,Michał Skrzypek ,Thomas M Macdonald,Alberico L Catapano ,Jacek Jerzy Jóźwiak

doi:10.3390/jcm10194472

Abstract

Background: The purpose of the study was to evaluate secondary stroke prevention in Poland and its association with sociodemographic factors, place of residence, and concomitant cardiovascular risk factors. Material and methods: From all patients in LIPIDOGRAM2015 Study (n = 13,724), 268 subjects had a history of ischaemic stroke and were included. Results: 165 subjects (61.6%) used at least one preventive medication. Oral antiplatelet and anticoagulation agents were used by 116 (43.3%) and 70 (26.1%) patients, respectively. Only 157 (58.6%) participants used lipid-lowering drugs, and 205 (76.5%) were treated with antihypertensive drugs. Coronary heart disease (CHD) and dyslipidaemia were associated with antiplatelet treatment (p = 0.047 and p = 0.012, respectively). A history of atrial fibrillation, CHD, and previous myocardial infarction correlated with anticoagulant treatment (p = 0.001, p = 0.011, and p < 0.0001, respectively). Age, gender, time from stroke onset, place of residence, and level of education were not associated with antiplatelet or anticoagulant treatment. Only 31.7% of patients were engaged in regular physical activity, 62% used appropriate diet, and 13.6% were current smokers. Conclusions: In Poland drugs and lifestyle modification for secondary stroke prevention are not commonly adhered to. Educational programmes for physicians and patients should be developed to improve application of effective secondary prevention of stroke.

Highlights

Stroke is the second most common cause of death and the leading cause of adult disability in developed countries
Among all the LIPIDOGRAM2015 Study participants (n = 13,724), 268 (2%) subjects, 141 women and 127 men, had a history of an ischaemic stroke and they were included in this analysis
HS—haemorrhagic stroke; Coronary heart disease (CHD)—coronary heart disease; AF—atrial fibrillation; DM—diabetes mellitus; HT—hypertension; CKD—chronic kidney disease; BMI—body mass index; OR-odds ratio; CI-confidence interval. Based on this analysis of the LIPIDOGRAM2015 Study, we demonstrate that approximately 60% of examined patients with a history of a previous stroke applied anticoagulants or antiplatelets as secondary pharmacological prevention

Summary

Introduction

Stroke is the second most common cause of death and the leading cause of adult disability in developed countries. Secondary stroke prevention includes lifestyle modification (regular physical activity, proper diet, body mass reduction, smoking cessation, and reducing alcohol intake), and elimination or reduction of risk factors responsible for the first stroke (in particular guideline-specified treatment of hypertension, dyslipidaemia and diabetes) [9,10,11,12,13]. The purpose of the study was to evaluate secondary stroke prevention in Poland and its association with sociodemographic factors, place of residence, and concomitant cardiovascular risk factors. Oral antiplatelet and anticoagulation agents were used by 116 (43.3%) and 70 (26.1%) patients, respectively. A history of atrial fibrillation, CHD, and previous myocardial infarction correlated with anticoagulant treatment (p = 0.001, p = 0.011, and p < 0.0001, respectively). 31.7% of patients were engaged in regular physical activity, 62%

Objectives

Methods

Results

Conclusion