22. European Stroke Conference 747 Stroke prevention Trend in anticoagulant therapy for ischemic stroke with non-valvular atrial fibrillation K. Takahashi1, M. Oda2, D. Obara3, H. Osawa4, T. Kikuchi5, H. Takahashi6 Department of Neurology, Iwate Prefectural Central Hospital, Morioka, JAPAN1, Department of Neurology, Iwate Prefectural Central Hospital, Morioka, JAPAN2, Department of Neurology, Iwate Prefectural Central Hospital, Morioka, JAPAN3, Department of Neurology, Iwate Prefectural Central Hospital, Morioka, JAPAN4, Department of Neurology, Iwate Prefectural Central Hospital, Morioka, JAPAN5, Department of Neurology, Iwate Prefectural Central Hospital, Morioka, JAPAN6 Background: Underuse and an inadequate warfarin use are still problems in the management of the patients with atrial fibrillation in clinical practice. We investigated the trend in preadmission anti-thrombotic therapy for ischemic stroke with non-valvular atrial fibrillation (NVAF). Methods: We reviewed medical records of 135 consecutive patients with acute ischemic stroke with NVAF who had been hospitalized in our department between April 2011 and March 2012. Therapeutic range of warfarin was defined as PT-INR 2.0-3.0(<70 years old) and 1.6-2.6(≧70 years old). Results: Among these 135 consecutive patients (73 men, mean age 80.7±8.9 years old), 45(33.3%) had paroxysmal atrial fibrillation(PAF) and the other had chronic atrial fibrillation(CAF). 51(38%) patients were on oral warfarin therapy, but only 14 patients were in a therapeutic range. 92(68%) patients were con-firmed NVAF by their primary care doctor before admission. Of the 92 patients, 43 (17 with PAF and 26 with CAF) did not receive anticoagulant therapy. Among 43 patients who were not adminis-tered anticoagulation, 3 had CHA2DS2-VASc score of 0-1. Patients with PAF had a higher risk of oral anticoagulation underuse compared to CAF (p=0.00035). Conclusion: Anticoagulant therapy in the NVAF patients, particularly PAF, was insufficient. It is necessary to evaluate the risk of stroke and adequate anticoagulant therapy in the management of the patients with NVAF. 740 © 2013 S. Karger AG, Basel Scientific Programme 748 Stroke prevention COMPLIANCE WITH STATIN THERAPY AFTER ISCHEMIC STROKE: ARE WE READY TO HIGH DOSES? E. Blanco-Vicente1, P. Martinez-Sanchez2, B. Fuentes3, M.A. Mangas-Guijarro4, O. Trabajos5, A. Martin-Montes6, E. Diez-Tejedor7 Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid. Madrid, SPAIN1, Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Uni-versidad Autónoma de Madrid., Madrid, SPAIN2, Department of Neurology and Stroke Centre. Idi- PAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN3, Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN4, Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Uni-versidad Autónoma de Madrid., Madrid, SPAIN5, Department of Neurology and Stroke Centre. Idi- PAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN6, Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN7 BACKGROUND: our objective was to analyze the 3-months adherence following statin initiation after an ischemic stroke. METHODS: Observational study of patients with cerebral infarction (CI) or transient ischemic at-tack treated at a Stroke Unit during 2009-2010. Variables analyzed: demographic data, vascular risk factors, stroke subtype, outcomes and treatment at discharge including statins, type and dose. The 3-months the compliance with statin treatment was registered and, if modified, who recommended the modification and the reasons for it. RESULTS: 798 patients included, 60% male, mean age 68.6 years, 81.7% with CI. Among the 789 survivors, 508 (63.7%) were prescribed statins at discharge, high dose in 258 cases. Three-month follow-up was performed to 447 patients treated with statins (87.9%) after the stroke: treatment was reduced in 4.7%, discontinued in 4%, changed by other statin in 0.9% and changed plus reduced doses in 1.6%. Statin discontinuation/reduction was due to adverse events in 15.2%, good lipid con-trol in 8.7%, other causes 4.3% and unknown in the rest. The primary care physician (PCP) recom-mended the 84.8% of the treatment modifications, although the causes were not justified in 69.6% of them. Multivariate analysis showed that treatment with high doses of statins after the stroke (OR 2.666, 95% CI 1.350 to 5.265) was the only predictor of statin discontinuation/reduction. CONCLUSION: One in 10 patients with ischemic stroke shows early low compliance to statins, over all in case of high dosis. Educacion programs are needed for patients and PCP to improve the adherence to statin therapy.
Karger_ESC London_2013
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