22. European Stroke Conference 765 Stroke prevention Recurrence,mortality & morbidity after stroke with relation to socioeconomic factors: An un-explored scenario in India. K. Das1, M. Ghosh2, C. Nag3 Burdwan Medical College, Burdwan, INDIA1, Burdwan Medical College, Burdwan, INDIA2, Burdwan Medical college, Burdwan, INDIA3 Background & Objectives Recurrence, morbidity & mortality after stroke is a burning issue in de-veloping country.Prospective observational study to evaluate the socioeconomic factors in rela-tion to discontinuation of secondary preventive treatment of stroke and its outcome in India Study Design :- Total 1420 stroke patients male : 840(59.15%), age 60± 2 year female : 580 age 58± 2 years, intra-cerebral hemorrhage 598(42.11%) and ischemic strokes 822(57.89%) enrolled in the stroke clinic for secondary preventive treatment were evaluated at 6 weeks Interval from Janu-ary 2007 to January 2010. Discontinuation of treatment for more than 2 weeks by any patient was placed in the discontinued group Outcome of every enrolled patient was evaluated for 1) Control of Risk factors 2) Recurrence of stroke 3) Disability status 4) Mortality. Reasons for discontinuation of treatment were comparatively analysed in respect to awareness, educational level, economy, dis-tance from the stroke clinic, cost of therapy, types of stroke and disability status. Results and Analy-sis:- During the study period of 3 years, 520(36.62%) patients discontinued the secondary preventive treatment, 130(9.36%) patients dropped out & 770(54.22%) patients continued. Chi-square and null hypothesis procedures were applied for statistical analysis. Distance, Economy, poor awareness, low educational level, types of stroke, disability status, cost of treatment all were significant socio-economic factors (P≤0.001, for all factors) with the relation to discontinuation of 2ndary preventive treatment resulting higher recurrence, mortality, disability and poor control of risk factors (P≤0.001 for all factors). Conclusion:-Discontinuation of secondary preventive treatment due to diverse socio-economic factors resulting in higher recurrence, mortality, disability among the stroke survivors is burning issue in India and developing countries and these should be intimated to national and inter-national stroke authorities to strengthen the preventive measures in developing countries for better outcome and reduction of stroke burden globally. 750 © 2013 S. Karger AG, Basel Scientific Programme 766 Stroke prevention Resistance to acetylsalicylic acid in patients with type 2 diabetes mellitus is associated with lip-id disorders and history of current smoking B. Labuz-Roszak1, K. Pierzchala2, K. Tyrpień3 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 Chemistry3 Background: Diabetes mellitus is an important risk factor for stroke. Acetylsalicylic acid (ASA) is the most frequently used medication for prevention of ischaemic cerebrovascular events in diabet-ic patients. However, some patients experience stroke despite the use of ASA. This phenomenon is known as “aspirin resistance” (AR). The aim of this study was the assess the incidence of AR in diabetic patients and search for factors associated with it. Material and method: The examined group consisted of 66 subjects with diagnosed diabetes mellitus type 2. Platelet function test was performed by the method of whole blood impedance aggregometry using multiple platelet function analyzer. Results: Among examined diabetic subjects, 35 patients (53%) were sensitive to ASA ac-tion (ASA-responders) and 31 patients (47%) were resistant to ASA action (ASA-non-responders). No relationship was found between platelet aggregation and gender, age, dose of ASA, known du-ration of diabetes, BMI, heart rate, mean systolic and diastolic blood pressure, and risk factors ex-cept for current smoking. ASA-non-responders were treated shorter with ASA than ASA-responders (p=0.008). The mean total cholesterol (p=0.04) and LDL concentration (p=0.01) were significantly higher in ASA-non-responders compared to ASA-responders. No relationship was found between the occurrence of ASA resistance and results of other laboratory tests and the intake of different medications. Conclusions: Results of our study did not confirm the association between poor glycae-mic control in the diabetic patients and AR. Resistance to ASA in diabetic patients is associated with lipid disorders and history of current smoking.
Karger_ESC London_2013
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