HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nickman, N. A. Articles by Brixner, D. I . Search for Related Content PubMed PubMed Citation Articles by Nickman, N. A. Articles by Brixner, D. I .

NANCY A. NICKMAN, PH.D., is Professor of Pharmacotherapy and Presidential Teaching Scholar, Pharmacotherapy Outcomes Research Center; and JOSEPH BISKUPIAK, PH.D., M.B.A., is Research Associate Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, College of Pharmacy, University of Utah (UU), Salt Lake City. FREDDYCREEKMORE, PHARM.D., BCPS, is Associate Professor and Vice Chair, Department of Pharmacy Practice, East Tennessee State University, Johnson City; at the time of writing he was Clinical Associate Professor of Pharmacotherapy, College of Pharmacy, UU.HEMAL SHAH, PHARM.D., is Director, Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals, Inc., Ridge-field, CT. DIANA I. BRIXNER, PH.D., is Associate Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, UU.

Address correspondence to Dr. Nickman at the Pharmacotherapy Outcomes Research Center, University of Utah, 421 Wakara Way, Suite 208, Salt Lake City, UT 84108 (nancy.nickman{at}pharm.utah.edu).

Purpose. The use of antiplatelet agents in patients hospitalized with ischemic stroke was studied. Methods. Patients with a primary or secondary diagnosis of noncardiogenic, thrombotic ischemic stroke from January 2002 through December 2004 were included in the analysis. Patients were then subdivided into four treatment groups and one no-treatment group based on whether they were charged for any of four antiplatelet regimens (low-dose aspirin [=325 mg daily], extended-release dipyridamole 200 mg with aspirin 25 mg, clopidogrel 75 mg, and clopidogrel 75 mg [as the bisulfate] plus low-dose aspirin) at any time during hospitalization. Patients who did not receive any of these medications during hospitalization were defined as the no-treatment group. A patient’s illness severity was measured and compared with other patients in the data set. Results. A total of 44,108 patients were assigned to the treatment group, and 14,255 patients were assigned to the no-treatment group. In general, longer lengths of stay and higher institutional costs were associated with the no-treatment group. Patients in the no-treatment group consistently displayed more comorbid conditions than did patients in the treatment group. The no-treatment group exhibited higher usage rates of both fibrinolytic agents and vitamin K. More patients in the treatment group were discharged to home or rehabilitation, while more patients in the no-treatment group were either discharged to another nursing facility or died before discharge. Conclusion. A retrospective analysis of a large national hospital database revealed that one quarter of patients who suffered an acute stroke did not receive antiplatelet drugs during their patient stay. Outcomes for such patients were poorer than for patients who had received antiplatelet therapy. Index terms: Aspirin; Cerebrovascular accident; Clopidogrel; Combined therapy; Costs; Dipyridamole; Dosage; Drug comparisons; Fibrinolytic agents; Hospitals; Platelet aggregation inhibitors; Vitamin K; Vitamins