关键词: 卒中; 抗栓治疗; 二级预防; 医疗服务

Abstract: Objective To assess the current status of antithrombotic drug use (including anticoagulant agentsand antiplatelet drugs) in patients with ischemic stroke(IS) or transient ischemic attack(TIA) inChina and to analyze the possible factors that may affect the use of these drugs.Methods A cross-sectional survey was performed to investigate the administration ofantithrombotic drugs in patients with IS or TIA from July 01 to August 15, 2006. All subjectsselected for the study represented consecutive cases diagnosed with IS or TIA at neurologicalclinics in major metropolitan cities in China. A total of 2283 IS or TIA patients from 19 hospitalswere included in the survey.Results Among 2283 patients, 75.6% were treated with antiplatelet drugs. A total of 71.9% patientsused aspirin, 4.2% used aspirin + clopidogrel, and 7.3% used clopidogrel. In addition, 81 of the ISor TIA patients had atrial fibrillation (AF), and 17.3% of these patients were treated with warfarin.Medical insurance (odds ratio [OR] 1.473, 95% confidence interval [CI ] 1.088–1.994), Medicaid (OR1.632, 95%CI 1.029–2.589), monthly income greater than RMB 500 yuan (OR 2.136, 95% CI 1.508–3.026), hypertension (OR 1.463, 95%CI 1.159–1.847), and lipid metabolism disorders (OR 1.499,95% CI 1.187–1.893) were predictors of antiplatelet drug treatment. In contrast, an age of 75 years orolder (OR 0.701, 95% CI 0.498–0.988) and a modified Rankin Scale (mRS) score of 4–5 (OR 0.684,95% CI 0.486–0.965) were predictors of antiplatelet drug non-use.Conclusion Current status of antithrombotic treatment among IS or TIA patients in the hospitals ofmajor metropolitan cities in China is inadequate. Effective strategies must be implemented to closethe gap between clinical guidelines and practice.

Key words: Stroke; Antithrombotic; Secondary Prevention; Healthcare Service