Caractérisation des profils de traitements pour accident vasculaire cérébral et événements cliniques associés
Data on drug-prescribing practices following an acute ischemic stroke (AIS), a major health problem, and secondary stroke prevention treatments’ effectiveness are scarce in a realworld setting. The aim of this thesis was to describe patterns of treatments prescribed in the Quebec community practice setting among incident AIS patients and to determine the risk of death or AIS recurrence. A retrospective cohort study of 5,587 incident AIS adult (age 18+) patients identified between 1st January 2011 and 31st December 2012 was conducted using the claims databases of the Régie de l’assurance maladie du Québec (RAMQ). In the month after discharge, the majority of patients (n=4,005; 71.7%) were receiving antithrombotic agents (anticoagulant and/or antiplatelet) while only 55.7% were taking these treatments according to the Canadian clinical guidelines. However, nearly one fifth (20.2%) of patients did not receive any prescribed treatment in the month following hospital discharge. Survival analyses showed that all treatments were associated with a 50% risk reduction of allcause mortality and AIS recurrence. Clinical efficacy of secondary stroke prevention treatments reported in randomized controlled trials seemed to be confirmed in a real-world setting.
Stroke Acute ischemic stroke treatment profiles secondary prevention mortality AIS recurrence