Analysis of Treatment Pattern of Antiplatelet in First-Ever Ischemic Stroke Without Previous Antiplatelet Use: A...

Area of Science:

• Cardiology
• Neurology
• Pharmacology

Background:

• Cardiovascular disease is a leading cause of death globally and second in Korea.
• Antiplatelet agents are crucial for preventing cardiovascular events.
• Understanding real-world antiplatelet prescribing patterns is essential due to increasing demand.

Purpose of the Study:

• To analyze antiplatelet prescription trends in patients with first-ever ischemic stroke (IS) in Korea.
• To assess the impact of the 2013 CHANCE trial on prescribing patterns.

Main Methods:

• Analysis of 162,361 patients with first-ever IS using 11 Korean observational databases (1995-2023).
• Data transformed to a Common Data Model.
• Prescription shifts evaluated in relation to the CHANCE trial publication.

Main Results:

• Initial antiplatelet therapy: Aspirin (39.4%), Aspirin-Clopidogrel (28.2%), Clopidogrel (13.7%).
• Post-CHANCE trial: Aspirin-Clopidogrel combination became dominant (40.6%), followed by Aspirin (30.3%) and Clopidogrel (11.3%) monotherapy.
• Significant shift towards dual antiplatelet therapy (DAPT) after the CHANCE trial.

Conclusions:

• The CHANCE trial significantly influenced the increased use of DAPT for secondary IS prevention.
• Aspirin remains a primary agent, but DAPT use has risen notably.
• Ongoing analysis of antiplatelet patterns is vital for guideline implementation in clinical practice.