Adherence to Dual Antiplatelet Therapy Protocol in Acute Ischemic Stroke

Area of Science:

• Neurology
• Cardiology
• Public Health

Background:

• Dual antiplatelet therapy (DAPT) is proven to reduce ischemic event recurrence in stroke and TIA patients.
• Timely administration and accurate dosage are critical for DAPT effectiveness.
• This study evaluates the implementation quality of a DAPT protocol at a single center.

Purpose of the Study:

• To assess the adherence to a DAPT protocol for mild stroke and high-risk TIA patients.
• To evaluate the timeliness of DAPT initiation within 48 hours of symptom onset.
• To identify areas for improvement in acute stroke treatment protocols.

Main Methods:

• Retrospective analysis of 11,180 patients from the Helsinki Stroke Quality Registry (HSQR).
• Inclusion criteria: DAPT (ASA and clopidogrel) initiated within 2 weeks of admission.
• Exclusion criteria: IV thrombolysis, thrombectomy, or prior DAPT.
• Analysis of DAPT initiation time, diagnoses, and risk scores (NIHSS, ABCD²).

Main Results:

• 299 patients met inclusion criteria; 263 (88.0%) had ischemic stroke or TIA.
• DAPT initiated within 48 hours by 197 patients (65.9%).
• Full adherence to all protocol criteria observed in 137 patients (45.8%).

Conclusions:

• Less than half of eligible patients fully adhered to the DAPT protocol.
• A significant proportion initiated DAPT within the recommended 48-hour window.
• Integrating DAPT into acute stroke treatment protocols is recommended to improve timely initiation and patient outcomes.