22. European Stroke Conference 783 Stroke prevention A multicenter study to assess the effect of the risk factors on Cardio&cerebrovascular events and Quality of life(EQ-5D) related to disability of StrokE(MRS) in patients with StrokE taking antiplatelet Agents(ACE Study) S.R. Han1, S.W. Jung2, S.B. Lee3, Y.S. Shim4, A.H. Jo5, J.W. Park6, Y.I. Kim7, Y.J. Kim8 The Catholic Uinveristy of Korea, Suwon, SOUTH KOREA1, The Catholic Uinveristy of Ko-rea, Incheon, SOUTH KOREA2, The Catholic Uinveristy of Korea, Daejeon, SOUTH KOREA3, The Catholic Uinveristy of Korea, Bucheon, SOUTH KOREA4, The Catholic Uinveristy of Korea, Seoul, SOUTH KOREA5, The Catholic Uinveristy of Korea, Uijeongbu, SOUTH KOREA6, The Catholic Uinveristy of Korea, Seoul, SOUTH KOREA7, Ehwa Womens University Hospital, Seoul, SOUTH KOREA8 Background & Objectives: We evaluated the effects of the number of risk factors on cardiocerebro-vascular events and the quality of life related to disability of stroke in patients with stroke taking an-tiplatelet agents. Method: This study was conducted at 8 hospitals with the patients 40 years or older diagnosed as stroke and prescribed Clopidogrel resinate. A total 581 patients were recruited between Jan 2010 and Oct 2010. All patients were treated with Clopidogrel for 6 months. The relation of the number and kind of risk factors(hypertension, diabetes mellitus, hyperlipidemia, stroke, concomi-tant cardiac diseases) at screening, control status of risk factors for 6 months and the pattern of oc-currence of cardiocerebrovascular events at 6 months were analyzed. Modified Rankin Scale(mRS) according to the quality of life (QoL) assessed using the EQ-5D quality of life based on the after effects were correlated. Safety was evaluated. Results: Two patients were showed cardiocerebrovas-cular events during the study. The one, who had thrombotic stroke, had three risk factors at screen-ing. The other, diagnosed with angina pectoris, had 4 risk factors. The number of patients with 2 risk factors are the most with 211 out of 581 patients(36.3%), followed by ones with 3(152 subjects, 26.2%), with 4(119, 20.5%), with 1(11.9%), with 5(5.0%), and with 6(0.2%). There was a signifi-cant negative correlation between the EQ-5D and mRS(r=-0.466, p<0.05). A total of 128 AEs were experienced by a total of 100 patients(16.1%) out of 623 total patients. Among these AEs, treat-ment- related AEs were 6 accounting for 1%, Related was 1, and possibly related was 5. Critical AEs occurred for 3 patients but it was not related with this investigational product. Conclusion: During this period, 2 patients had cerebrocardiovascular disease accounting 0.34%, and only 1% patients showed AE. The higher mMS, the less EQ-5D VAS score. Therefore this can be considered as sig-nificant 760 © 2013 S. Karger AG, Basel Scientific Programme and safe drug. 784 Stroke prevention Prescription practice in oral anticoagulation after cardioembolic strokes with the advent of the novel oral anticoagulants in two tertiary care centers in Germany W. Pfeilschifter1, C. Hohmann2, T. Neumann-Haefelin3, C. Foerch4 Goethe University Hospital, Frankfurt am Main, GERMANY1, Klinikum Fulda, Fulda, GER-MANY2, Klinikum Fulda, Fulda, GERMANY3, Goethe University Hospital, Frankfurt am Main, GERMANY4 Background and Purpose: Approximately one year ago, dabigatran (EU approval in August 2011) and rivaroxaban (December 2011) were introduced for stroke prevention in patients with atrial fibril-lation with a CHADS-VASc Score > 2. Both drugs have demonstrated non-inferiority compared to warfarin. We aimed to characterize factors independently associated with the prescription of novel oral anticoagulants (NOA) for secondary prevention in patients with stroke and atrial fibrillation. Methods: We screened the records of all stroke patients treated in the Stroke Units of our tertiary care centers from 10/2011 to 09/2012 for cases of stroke and atrial fibrillation. Patients age, sex, premorbid mRS, NIHSS at admission, mRS at discharge, arterial hypertension, diabetes mellitus, creatinine levels in serum, antiaggregation (antiplatelets and/or anticoaguloants) at admission and at discharge were recorded. We performed a multivariate logistic regression analysis to identify factors independently associated with the prescription of NOA. Results: We identified 449 patients with stroke and atrial fibrillation. At discharge from our Stroke Units, 27 % of patients were on warfarin, 22 % on NOA (16 % on dabigatran, 6 % on rivaroxaban) and 38 % on ASA or clopidogrel. For most of the latter, the initiation of anticoagulation was rec-ommended to the rehabilitation center or the general practitioner. Younger age (OR 0.96; 95 % CI 0.93-1.0, p = 0.027), better premorbid mRS status (0.72; 0.53-0.; p = 0.031), better mRS status at discharge (0.7; 0.57-0.87; p=0.001), and most strongly a lower creatinine level (0.26; 0.12- 0.56; p < 0.001) were negatively correlated with the prescription of NOA. This decision was not independent-ly influenced by the patients’ gender. Conclusions: In our analysis, we identified patients’ age, pre- and post-stroke functional neurologi-cal status and renal function as critical determinants in the decision to use NOA for secondary pre-vention after a cardioembolic stroke.
Karger_ESC London_2013
To see the actual publication please follow the link above