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Secondary Stroke Pr...
Secondary Stroke Prevention After Ischemic Stroke in Patients with Alzheimer's Disease and Other Dementia Disorders
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- Zupanic, Eva (author)
- Karolinska Institutet,University of Ljubljana,University Medical Centre Ljubljana
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- Kramberger, Milica G. (author)
- Karolinska Institutet,University of Ljubljana,University Medical Centre Ljubljana
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- von Euler, Mia, 1967- (author)
- Karolinska Institutet,Karolinska University Hospital
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- Norrving, Bo (author)
- Lund University,Lunds universitet,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Stroke policy och kvalitetsregisterforskning,Clinical Stroke Research Group,Lund University Research Groups,Stroke policy and quality register research
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- Winblad, Bengt (author)
- Karolinska Institutet,Karolinska University Hospital
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- Secnik, Juraj (author)
- Karolinska Institutet
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- Fastbom, Johan (author)
- Stockholm University,Karolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI)
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- Eriksdotter, Maria (author)
- Karolinska Institutet,Karolinska University Hospital
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- Garcia-Ptacek, Sara (author)
- Karolinska Institutet,Stockholm South General Hospital
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(creator_code:org_t)
- Amsterdam : IOS Press, 2020
- 2020
- English.
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In: Journal of Alzheimer's Disease. - Amsterdam : IOS Press. - 1387-2877 .- 1875-8908. ; 73:3, s. 1013-1021
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Abstract
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- BACKGROUND: Recurrent ischemic stroke (IS) increases the risk of cognitive decline. To lower the risk of recurrent IS, secondary prevention is essential.OBJECTIVE: Our aim was to compare post-discharge secondary IS prevention and its maintenance up to 3 years after first IS in patients with and without Alzheimer's disease and other dementia disorders.METHODS: Prospective open-cohort study 2007-2014 from the Swedish national dementia registry (SveDem) and the Swedish national stroke registry (Riksstroke). Patients with dementia who experienced an IS (n = 1410; 332 [23.5%] with Alzheimer's disease) were compared with matched non-dementia IS patients (n = 7150). We analyzed antiplatelet, anticoagulant, blood pressure lowering, and statin treatment as planned medication initiation at discharge and actual dispensation of medications at first, second, and third year post-stroke.RESULTS: At discharge, planned initiation of medication was higher in patients with dementia compared to non-dementia patients for antiplatelets (OR with 95% CI for fully adjusted models 1.23 [1.02-1.48]) and lower for blood pressure lowering medication (BPLM; 0.57 [0.49-0.67]), statins (0.57 [0.50-0.66]), and anticoagulants (in patients with atrial fibrillation - AF; 0.41 [0.32-0.53]). When analysis for antiplatelets was stratified according to the presence of AF, ORs for receiving antiplatelets remained significant only in the presence of AF (in the presence of AF 1.56 [1.21-2.01], in patients without AF 0.99 [0.75-1.33]). Similar trends were observed in 1st, 2nd, and 3rd year post-stroke.CONCLUSIONS: Dementia was a predictor of lower statin and BPLM use. Patients with dementia and AF were more likely to be prescribed antiplatelets and less likely to receive anticoagulants.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Annan medicin och hälsovetenskap -- Gerontologi, medicinsk/hälsovetenskaplig inriktning (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Other Medical and Health Sciences -- Gerontology, specialising in Medical and Health Sciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Alzheimer’s disease
- anticoagulants
- antihypertensive agents
- cohort studies
- dementia
- hydroxymethylglutaryl-CoA reductase inhibitors
- ischemic stroke
- platelet aggregation inhibitors
- secondary prevention
- Alzheimer’s disease
- anticoagulants
- antihypertensive agents
- cohort studies
- dementia
- hydroxymethylglutaryl-CoA reductase inhibitors
- ischemic stroke
- platelet aggregation inhibitors
- secondary prevention
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Zupanic, Eva
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Kramberger, Mili ...
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von Euler, Mia, ...
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Norrving, Bo
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Winblad, Bengt
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Secnik, Juraj
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show more...
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Fastbom, Johan
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Eriksdotter, Mar ...
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Garcia-Ptacek, S ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Geriatrics
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Other Medical an ...
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and Gerontology spec ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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Journal of Alzhe ...
- By the university
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Örebro University
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Stockholm University
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Karolinska Institutet
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Lund University