Pharmacotherapy prior to and in acute ischaemic stroke. The use of pharmacotherapy and drugs-associated outcomes in real-world practice – findings from the Polish Hospital Stroke Registry

Abstract

The prevention of ischaemic stroke needs to be monitored and improved. Evidence-based treatment of acute ischaemic stroke requires further promotion. The benefits of acute ischaemic stroke treatment with statins require to be confirmed in randomized controlled settings.

Pharmacotherapy prior to and in acute haemorrhagic stroke. The use of pharmacotherapy and drugs-associated outcomes in real-world practice – findings from the Polish Hospital Stroke Registry

“…During 1990s the incidence of anticoagulant-associated ICH quintupled in United States and the majority of this change was attributed to increased warfarin use [8]. In our study, 21% of AF patients prior to haemorrhagic stroke were reported oral anticoagulants users (twice more often than AF patients hospitalized with ischaemic stroke) [6]. The corresponding values in other studies were similar and ranged from 18.3 to 23.4% [9,10].…”

“…Alike for ischaemic stroke, drug utilisation before cerebrovascular accident and in acute haemorrhagic stroke is important in monitoring of the current medical practice. It can also point out pharmacotherapy potential benefit or harm in real-world settings as reported for ischaemic stroke patients [6]. Data from the Polish Hospital Stroke Registry provide a unique opportunity both to evaluate the current practice and to provide evidence on possible drug related benefit in haemorrhagic stroke based on everyday clinical practice data.…”

“…In the INTERSTROKE study, hypertension (defined as blood pressure > 160/90 mm Hg) was more often observed in haemorrhagic then ischaemic stroke patients (83 and 66%, respectively) and authors concluded that almost three quarters of haemorrhagic stroke risk is attributable to high blood pressure [7]. In the Polish Hospital Stroke Registry, antihypertensive drugs were used prior to haemorrhagic stroke on average by two out of three patients with hypertension and substantially less commonly compared to 75% of patients with ischaemic stroke [6]. We lack data on effectiveness of blood pressure control with antihypertensive prior to stroke in the Polish Hospital Stroke Registry.…”

“…Antiplatelets before haemorrhagic stroke onset were used only by quarter of patients with history of myocardial infarction or ischaemic heart disease and slightly more often in patients with secondary stroke. Moreover the antiplatelets were generally twice less often used for haemorrhagic stroke patients with history of cardiovascular disease compared with ischaemic stroke patients [6].…”

Efficacy of Combined Antithrombotic, Statins and Anti-Hypertensive Drugs in Acute Ischemic Stroke

“…Study reported oral anticoagulants or statins used in hospital were associated with better stroke outcome. 23 Similarly, a study on potential effects of statins initiated before or within four weeks of stroke demonstrated that post stroke statins were associated with a significant probability of a favorable outcome at 90 days. 24 However, the Chinese Acute Stroke Trial showed that the rates of long-term complete recovery or death and disability were not significantly improved in patients treated with aspirin.…”