Labuz-Roszak Beata, Banach Maciej, Skrzypek Michal, Windak Adam, Tomasik Tomasz, Mastej Miroslaw, Tomaszewski Maciej, Mikhailidis Dimitri P, Toth Peter P, Catapano Alberico, Ray Kausik K, Howard George, Lip Gregory Y H, Charchar Fadi J, Sattar Naveed, Williams Bryan, MacDonald Thomas M, Penson Peter, Jozwiak Jacek J
Department of Neurology, Institute of Medical Sciences, University of Opole, 45-052 Opole, Poland.
Polish Mothers Memorial Hospital Research Institute, 93-338 Lodz, Poland.
J Clin Med. 2021 Sep 28;10(19):4472. doi: 10.3390/jcm10194472.
The purpose of the study was to evaluate secondary stroke prevention in Poland and its association with sociodemographic factors, place of residence, and concomitant cardiovascular risk factors.
From all patients in LIPIDOGRAM2015 Study ( = 13,724), 268 subjects had a history of ischaemic stroke and were included.
165 subjects (61.6%) used at least one preventive medication. Oral antiplatelet and anticoagulation agents were used by 116 (43.3%) and 70 (26.1%) patients, respectively. Only 157 (58.6%) participants used lipid-lowering drugs, and 205 (76.5%) were treated with antihypertensive drugs. Coronary heart disease (CHD) and dyslipidaemia were associated with antiplatelet treatment ( = 0.047 and = 0.012, respectively). A history of atrial fibrillation, CHD, and previous myocardial infarction correlated with anticoagulant treatment ( = 0.001, = 0.011, and < 0.0001, respectively). Age, gender, time from stroke onset, place of residence, and level of education were not associated with antiplatelet or anticoagulant treatment. Only 31.7% of patients were engaged in regular physical activity, 62% used appropriate diet, and 13.6% were current smokers.
In Poland drugs and lifestyle modification for secondary stroke prevention are not commonly adhered to. Educational programmes for physicians and patients should be developed to improve application of effective secondary prevention of stroke.
本研究旨在评估波兰的二级卒中预防情况及其与社会人口学因素、居住地点和并存的心血管危险因素之间的关联。
从LIPIDOGRAM2015研究的所有患者（n = 13724）中，纳入268例有缺血性卒中病史的受试者。
165例受试者（61.6%）使用了至少一种预防性药物。分别有116例（43.3%）和70例（26.1%）患者使用了口服抗血小板药物和抗凝药物。仅有157例（58.6%）参与者使用了降脂药物，205例（76.5%）接受了降压药物治疗。冠心病（CHD）和血脂异常与抗血小板治疗相关（分别为P = 0.047和P = 0.012）。房颤病史、CHD和既往心肌梗死与抗凝治疗相关（分别为P = 0.001、P = 0.011和P < 0.0001）。年龄、性别、卒中发病时间、居住地点和教育程度与抗血小板或抗凝治疗无关。仅有31.7%的患者进行规律体育活动，62%采用适当饮食，13.6%为当前吸烟者。
在波兰，二级卒中预防的药物治疗和生活方式改变未得到普遍遵循。应制定针对医生和患者的教育项目，以改善有效的二级卒中预防措施的应用。
