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22. European Stroke Conference 769 Stroke prevention Impact of new drugs on anticoagulant prescription rate - a new era? L.I. Pereira1, M. Rodrigues2 Hospital Garcia de Orta, EPE, Almada, PORTUGAL1, Hospital Garcia de Orta, EPE, Almada, PORTUGAL2 Background Oral anticoagulation is recommended to prevent ischemic stroke (IS) in all patients with atrial fibrillation (AF), except those at low risk. In August 2011 new drugs like dabigatran were approved in this setting. We performed a comparative analysis before and after the launch of new oral anticoagulants (OAC), reporting anticoagulation rates and chronological evolution of prescription trends. Methods Retrospective observational study in IS patients admitted to a Neurology ward from 01/10/2010 to 30/09/2012. Demographics, clinical data, AF diagnosis, indications and contraindica-tions to OAC, and drug prescribed on discharge were recorded. We report rates with point estimates, and use chi-square and t-test to compare variables. Results Of 462 patients, cardioembolism was the presumed etiology in 24.0%, 21.9% (101 patients, 52.5% male, median age 73) with non-valvular AF (NVAF). Hypertension was found in 82.2%, 55.4% had dyslipidemia, and 39.6% diabetes. 31.7% had recurrent stroke and 35.6% underwent fi-brinolysis. 752 © 2013 S. Karger AG, Basel Scientific Programme From the second half of 2011 on, population characteristics changed, with higher prevalences of females (39.2% vs 27.8%, p=0.01), elderly (mean age 65.0 vs 62.7, p=0.05) and fewer past strokes (25.4% vs 36.4%, p=0.01). There were no differences among other risk factors. Of NVAF patients, 90.0% were discharged under anticoagulation. OAC prescription rates rose from the third trimester of 2011 on (70.8% vs 97.0%, p=0.001), when the new OAC were approved for NVAF. From August 2011 on the new OAC were preferred in 55.4%. Patients prescribed vitamin K antagonists had other indication for OAC in 24.1% and contraindication for new OAC because of renal failure in 7.4%. Conclusion Marketing of new drugs allowed more patients to get the best secondary prevention strategy. However, simultaneous co-morbidities, for which new OAC have not been tested or are contraindicated, still limit more generalized use. Registries in this field are warranted. 770 Stroke prevention Secondary prevention of stroke in elderly people in Poland B. Labuz-Roszak1, K. Pierzchala2, M. Skrzypek3, A. Machowska-Majchrzak4 Silesian University of Medicine, Department of Neurology, Zabrze, POLAND1, Silesian Univer-sity of Medicine, Department of Neurology, Zabrze, POLAND2, Silesian University of Medicine, Department of Biostatistics, Faculty of Public Health, Katowice, POLAND3, Silesian University of Medicine, Department of Neurology, Zabrze, POLAND4 Background: The purpose of the study was to evaluate the frequency of use of oral antiplatelet (OAP) and anticoagulant (OAC) drugs as secondary stroke prevention among older people in Po-land and its association with sociodemographic factors, place of residance, and concomitant cardio-vascular risk factors. Methods: The study was based on data collected during the implementation of a multicentre, publicly funded research project called PolSenior. Results: The study group consisted of 426 people with a history of a previous stroke in the mean age of 81.5+/-8.2 years. Among them, 261 people (61.27%) used at least one drug as the secondary prevention. OAPs were regularly used by 237 people (55.63%), and OACs - by 25 people (5.87%). The most often used drug was ASA. Ticlopidine was more frequently used than clopidogrel, and acenocoumarol – than warfarin. Among all of the concomitant cardiovascular risk factors, congestive heart failure was most associated with OAP treatment, and a history of atrial fibrillation - with OAC treatment. Use of drugs did not depend on age, sex, place of residence (rural or urban), level of education and personal income, but it was associated with the province where the respondents lived. Conclusions: In Poland secondary car-diovascular preventive therapy is used too rarely in older people after stroke, especially it concerns anticoagulant therapy in those with a history of atrial fibrillation. Structured educational programs should be developed in Poland to improve usage of secondary preventive therapy in the elderly.


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