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Research paper
Secondary prevention in patients with vascular disease. A population based study on the underuse of recommended medications
  1. Yannick Béjot1,
  2. Marianne Zeller2,
  3. Luc Lorgis2,
  4. Odile Troisgros3,
  5. Corine Aboa-Eboulé1,2,
  6. Guy-Victor Osseby1,
  7. Maurice Giroud1,
  8. Yves Cottin1
  1. 1Department of Neurology, Dijon Stroke Registry, EA4184, Medical School and University Hospital of Dijon, University of Burgundy, Dijon, France
  2. 2Observatoire des Infarctus de Côte-d'Or (RICO), LPPCE, IFR Santé-STIC, University of Burgundy, University of Hospital and Medical School of Dijon, Dijon, France
  3. 3Department of Rehabilitation, University Hospital of Dijon, Dijon, France
  1. Correspondence to Dr Y Béjot, Department of Neurology, Service de Neurologie, Dijon Stroke Registry, Hôpital Général, 3 Rue du Faubourg Raines, Dijon 21033, France; ybejot{at}yahoo.fr

Abstract

Objectives To investigate the premorbid use of secondary prevention medications in patients with recurrent vascular events.

Design Prospective, observational, population based study.

Setting The Dijon Stroke Registry and the registry of myocardial infarction of Dijon and Côte d'Or, France.

Patients All patients with cerebral ischaemia (ischaemic stroke or transient ischaemic attacks) or coronary artery disease (CAD) and a history of vascular disease (cerebral ischaemia, CAD or peripheral arterial disease (PAD)) in Dijon, France from 2006 to 2010.

Main outcome measures Data on medical history and prior use of treatments were collected. Mutivariate analyses were performed to identify predictors of the use of medications.

Results 867 patients (614 cerebral ischaemia and 253 CAD) were recorded including 448 (51.7%) with a history of cerebral ischaemia only, 191 (22.0%) with a history of CAD only, 68 (7.8%) with a history of PAD only and 160 (18.5%) with a history of polyvascular disease. In these 867 patients, 57.3% were on antithrombotic therapy, 61.2% were treated with antihypertensive drugs, 32.9% received statins and only 23.6% were on an optimal regimen, defined as a combination of the three therapies. Compared with patients with previous CAD only, those with previous cerebral ischaemia only were less likely to be receiving each of these treatments or to receive an optimal regimen (OR=0.17, 95% CI 0.14 to 0.26, p<0.001).

Conclusions Our findings underline the fact that the underuse of secondary preventive therapies is common in patients with recurrent vascular events, especially those with previous cerebral ischaemia. This underuse could be targeted to reduce recurrent vascular events.

  • Stroke

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