Use of antiplatelet drugs in the stroke unit of a Hong Kong hospital.

Objective: Antiplatelet drugs are widely used for secondary prevention of thrombotic cerebrovascular disease. The antiplatelet prescribing patterns has been evaluated in several studies but data about Hong Kong patients are lacking. This study is to investigate the prescribing patterns of antiplatelet agents in a Hong Kong hospital.

Method: All patients over 18 years, who attended the stroke unit between 1 October 2002 and 31 December 2002 and were on antiplatelet therapy were included in the study. Data were collected through retrospective chart review and recorded on a standardized data collection form. Continuous and categorical data were expressed as mean and counts respectively. Factors that determine frequency and pattern of antiplatelet therapy were assessed in multiple logistic regression models.

Results: Three hundred and nineteen patients were included in the study. Aspirin and clopidogrel accounted for 82.1 and 16.3 of all prescriptions respectively and remaining patients were on aspirin/dipyridamole. Patients with no history of aspirin use were less likely to be treated with clopidogrel compared with those experienced aspirin intolerance (OR=0.004, 95 CI 0.000-0.051). Patients with history of gastrointestinal (GI) diseases were more likely to receive clopidogrel than those had no history of GI disorders (OR=154.86, 95 CI 33.76-710.38). Atrial fibrillation (AF) was positively associated with clopidogrel prescription (OR=11.83, 95 CI 1.21-115.85). In addition, patients with concomitant gastroprotective drugs received clopidogrel significantly less often than those without gastroprotective agents (OR=0.06, 95 CI 0.01-0.29).

Conclusion: Use of antiplatelet agents in patients receiving antiplatelet therapy of the stroke unit has complied with existing evidences. Several factors that determine choice between aspirin and clopidogrel were identified which included history of aspirin use and GI disorders, AF and co-prescribed gastroprotective drugs.