Abstract
Objective: Antiplatelet drugs are widely used for secondary prevention of thrombotic cerebrovascular disease. The antiplatelet prescribing patterns has been evaluated in several studies but data about Hong Kong patients are lacking. This study is to investigate the prescribing patterns of antiplatelet agents in a Hong Kong hospital.
Method: All patients over 18 years, who attended the stroke unit between 1 October 2002 and 31 December 2002 and were on antiplatelet therapy were included in the study. Data were collected through retrospective chart review and recorded on a standardized data collection form. Continuous and categorical data were expressed as mean and counts respectively. Factors that determine frequency and pattern of antiplatelet therapy were assessed in multiple logistic regression models.
Results: Three hundred and nineteen patients were included in the study. Aspirin and clopidogrel accounted for 82.1 and 16.3 of all prescriptions respectively and remaining patients were on aspirin/dipyridamole. Patients with no history of aspirin use were less likely to be treated with clopidogrel compared with those experienced aspirin intolerance (OR=0.004, 95 CI 0.000–0.051). Patients with history of gastrointestinal (GI) diseases were more likely to receive clopidogrel than those had no history of GI disorders (OR=154.86, 95 CI 33.76–710.38). Atrial fibrillation (AF) was positively associated with clopidogrel prescription (OR=11.83, 95 CI 1.21–115.85). In addition, patients with concomitant gastroprotective drugs received clopidogrel significantly less often than those without gastroprotective agents (OR=0.06, 95 CI 0.01–0.29).
Conclusion: Use of antiplatelet agents in patients receiving antiplatelet therapy of the stroke unit has complied with existing evidences. Several factors that determine choice between aspirin and clopidogrel were identified which included history of aspirin use and GI disorders, AF and co-prescribed gastroprotective drugs.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
InstitutionalAuthorNameAntithrombotic Trialists’ Collaboration. (2002) ArticleTitleCollaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients BMJ 324 71–86
GW Albers JGP. Tijssen (1999) ArticleTitleAntiplatelet therapy: new foundations for optimal treatment decisions Neurology 53 S25–S31 Occurrence Handle10532645
K. Schror (1995) ArticleTitleAntiplatelet drugs Drugs 50 7–28 Occurrence Handle7588091
InstitutionalAuthorNameCAPRIE Steering Committee. (1996) ArticleTitleA randomised, blinded trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE) Lancet 348 1329–38
PB Gorelick GVR Born RB D’Agostino DF Hanley L Moye CJ. Pepine (1999) ArticleTitleTherapeutic benefit: aspirin revisited in light of the introduction of clopidogrel Stroke 30 1716–21 Occurrence Handle10436127
W Lalouschek W Lang M. Mullner (2001) ArticleTitleCurrent strategies of secondary prevention after a cerebrovascular event: The Vienna Stroke Registry Stroke 32 2860–6 Occurrence Handle11739988
TO Mayer J. Biller (2003) ArticleTitleAntiplatelet prescribing patterns for TIA and ischemic stroke: the Indiana University experience J Neurol Sci 8794 1–6
HC Diener L Cunha C Forbes J Sivenius P Smets A. Lowenthal (1996) ArticleTitleEuropean stroke prevention study 2: dipyridamole and acetylsalicylic acid in the secondary prevention of stroke J Neurol Sci 143 1–13 Occurrence Handle8981292
SB Jaglal V Goel CO. Naylor (1994) ArticleTitleSex differences in the use of invasive coronary procedures in Ontario Can J Cardiol 10 239–44 Occurrence Handle8143225
Holroyd-Leduc JM, Kapral MK, Austin PC, Tu JV. (2000). Sex differences and similarities in the management and outcome of stroke patient. Stroke 1833–37
JM Gaspoz PG Coxson PA Goldman LW Williams KM Kuntz M Hunink L. Goldman (2002) ArticleTitleCost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease N Engl J Med 346 1800–06 Occurrence Handle10.1056/NEJM200206063462309 Occurrence Handle12050341
MM Wolfe DR Lichtenstein G. Singh (1999) ArticleTitleGastrointestinal toxicity of nonsteroidal antiinflammatory drugs N Engl J Med 340 1888–99 Occurrence Handle10.1056/NEJM199906173402407 Occurrence Handle10369853
JR Vane RM. Botting (1998) ArticleTitleMechanism of Action of Nonsteroidal Anti-inflammatory Drugs Am J Med 104 2S–8S Occurrence Handle10.1016/S0002-9343(97)00203-9
FKL Chan WK. Leung (2002) ArticleTitlePeptic-ulcer disease Lancet 360 933–40 Occurrence Handle10.1016/S0140-6736(02)11030-0 Occurrence Handle12354485
Seey SC Ng KS Tho SK. Teo (1998) ArticleTitleAre antacids necessary as routine prescriptives with non-steroidal anti-inflammatory drugs Ann Acad Med Singap 27 219–22 Occurrence Handle9663314
M LazzaroniM. Sainaghi PG. Bianchi (1999) ArticleTitleNon-steroidal anti-inflammatory drug gastropathy: clinical results with antacids and sucralfate Ital J Gastroenterol Hepatol 31 S48–S53 Occurrence Handle10379470
G Singh G. Triadafilopoulos (1999) ArticleTitleEpidemiology of NASID induced gastrointestinal complications J Rheumatology 26 IssueIDSuppl 56 18–24
G. Singh (1998) ArticleTitleRecent considerations in nonsteroidal anti-inflammatory drug gastropathy Am J Med 105 IssueID18 31S–38S Occurrence Handle10.1016/S0002-9343(98)00072-2 Occurrence Handle9715832
InstitutionalAuthorNameInternational Stroke Trial Collaborative Group. (1997) ArticleTitleThe international stroke trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischemic stroke Lancet 349 1569–81
InstitutionalAuthorNameCAST (Chinese Acute Stroke Trial) Collaborative Group. (1997) ArticleTitleCAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischemic stroke Lancet 349 1641–49
CJ Vaughan N Delanty CT. Basson (2001) ArticleTitleStatin therapy and stroke prevention Curr Opin Cardiol 16 219–24 Occurrence Handle10.1097/00001573-200107000-00001 Occurrence Handle11574782
PB. Gorelick (2002) ArticleTitleStroke prevention therapy beyond antithrombotics: unifying mechanisms in ischemic stroke pathogenesis and implications for therapy Stroke 33 862–75 Occurrence Handle10.1161/hs0302.103657 Occurrence Handle11872916
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Luk, H.H., Pang, J., Li, L.S.W. et al. Use of Antiplatelet Drugs in the Stroke Unit of a Hong Kong Hospital. Pharm World Sci 27, 258–262 (2005). https://doi.org/10.1007/s11096-004-7754-z
Issue Date:
DOI: https://doi.org/10.1007/s11096-004-7754-z