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Secondary prevention after ischaemic stroke: the ASPIRE-S study.
- Source :
- BMC Neurology; 10/23/2015, Vol. 15 Issue 1, p1-8, 8p, 3 Charts, 1 Graph
- Publication Year :
- 2015
-
Abstract
- <bold>Background: </bold>Survivors of ischaemic stroke (IS) are at high-risk for future vascular events. Comprehensive information on the adequacy of secondary prevention after IS is lacking despite the knowledge that appropriate secondary prevention improves long-term patient outcomes. ASPIRE-S (Action on Secondary Prevention Interventions and Rehabilitation in Stroke) aimed to prospectively assess secondary prevention in patients 6 months following IS.<bold>Methods: </bold>Consenting patients admitted with IS to three Dublin hospitals were recruited over 1 year, from October 2011. At 6 months post IS a comprehensive assessment was completed, modelled on the EUROASPIRE protocol for evaluation of the adequacy of secondary prevention in post-discharge cardiac patients. This assessment included measurements of blood pressure, body mass index and fasting lipid and glucose profiles. Secondary preventive medications and smoking status were also documented.<bold>Results: </bold>Three hundred two patients (58 % male) participated, of whom 256 (85 %) were followed-up at 6 months. Mean age was 69 years (range 22-95). At follow-up, 68 % of patients had a BMI >25 kg/m(2) and 16.4 % were still smoking. Almost two-thirds (63.4 %) had a blood pressure >140/90 and 23 % had low-density-lipoprotein >2.5 mmol/L. 28 % of diabetic patients had HbA1c ≥ 7 %. Ninety seven percent of patients were on anti-platelet and/or anticoagulant therapy. Of those with atrial fibrillation, 82 % were anti-coagulated (mean INR of 2.4). Ninety-five percent were on lipid-lowering therapy and three-quarters were on anti-hypertensive therapy.<bold>Conclusion: </bold>This prospective multi-centre survey of IS patients demonstrated a high prevalence of remaining modifiable risk factors at 6 months post stroke, despite the widespread prescription of secondary preventive medications. There is scope to improve preventive measures after IS (in particular blood pressure) by incorporating evidence-based guidelines into quality assurance cycles in stroke care. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14712377
- Volume :
- 15
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 110575989
- Full Text :
- https://doi.org/10.1186/s12883-015-0466-2