Long-term risk-factor control and secondary prevention are insufficient after first TIA : Results from QregPV
INTRODUCTION: Long-term risk-factor control and secondary prevention are not well characterized in patients with a first transient ischemic attack (TIA). With baseline levels as reference, we compared primary-care data on blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), smoking, and use of antihypertensives, statins and antiplatelet treatment/oral anticoagulation (APT/OAC) during 5 years after a first TIA.
PATIENTS AND METHODS: Patients in QregPV, a Swedish primary-care register for the Region of Västra Götaland, with a first TIA discharge diagnosis from wards proficient in stroke care 2010 to 2012 were identified and followed up to 5 years. BP, LDL-C, smoking, use of antihypertensives, statins, APT/OAC, and achievement of target levels were calculated. We used logistic mixed-effect models to analyze the effect of follow-up over time on risk-factor control and secondary prevention treatment.
RESULTS: We identified 942 patients without prior cerebrovascular disease who had a first TIA. Compared to baseline, the first year of follow-up was associated with improvements in concomitant attainment of BP <140/90 mmHg, LDL-C < 2.6 mmol/L and non-smoking, which rose from 20% to 33% (OR 2.08, 95% CI 1.38-3.13), but then stagnated in years 2-5. In the first year of follow-up, 47% of patients had complete secondary prevention treatment (antihypertensives, APT/OAC and statin), but continued follow-up was associated with a yearly decrease in secondary prevention treatment (OR 0.94, 95% CI 0.94-0.98).
CONCLUSION: Risk-factor control was inadequate, leaving considerable potential for improved secondary prevention treatment after a first TIA in Swedish patients followed up to 5 years.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
European stroke journal - 9(2024), 1 vom: 29. März, Seite 154-161 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bager, Johan-Emil [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 06.03.2024 Date Revised 08.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/23969873231215629 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Long-term risk-factor control and secondary prevention are insufficient after first TIA |b Results from QregPV |
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| 500 | |a Date Revised 08.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: Long-term risk-factor control and secondary prevention are not well characterized in patients with a first transient ischemic attack (TIA). With baseline levels as reference, we compared primary-care data on blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), smoking, and use of antihypertensives, statins and antiplatelet treatment/oral anticoagulation (APT/OAC) during 5 years after a first TIA | ||
| 520 | |a PATIENTS AND METHODS: Patients in QregPV, a Swedish primary-care register for the Region of Västra Götaland, with a first TIA discharge diagnosis from wards proficient in stroke care 2010 to 2012 were identified and followed up to 5 years. BP, LDL-C, smoking, use of antihypertensives, statins, APT/OAC, and achievement of target levels were calculated. We used logistic mixed-effect models to analyze the effect of follow-up over time on risk-factor control and secondary prevention treatment | ||
| 520 | |a RESULTS: We identified 942 patients without prior cerebrovascular disease who had a first TIA. Compared to baseline, the first year of follow-up was associated with improvements in concomitant attainment of BP <140/90 mmHg, LDL-C < 2.6 mmol/L and non-smoking, which rose from 20% to 33% (OR 2.08, 95% CI 1.38-3.13), but then stagnated in years 2-5. In the first year of follow-up, 47% of patients had complete secondary prevention treatment (antihypertensives, APT/OAC and statin), but continued follow-up was associated with a yearly decrease in secondary prevention treatment (OR 0.94, 95% CI 0.94-0.98) | ||
| 520 | |a CONCLUSION: Risk-factor control was inadequate, leaving considerable potential for improved secondary prevention treatment after a first TIA in Swedish patients followed up to 5 years | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Transient ischemic attack | |
| 650 | 4 | |a cerebrovascular disease | |
| 650 | 4 | |a hypertension | |
| 650 | 4 | |a low-density lipoprotein cholesterol | |
| 650 | 4 | |a primary health care | |
| 650 | 4 | |a smoking | |
| 650 | 7 | |a Hydroxymethylglutaryl-CoA Reductase Inhibitors |2 NLM | |
| 650 | 7 | |a Cholesterol, LDL |2 NLM | |
| 650 | 7 | |a Antihypertensive Agents |2 NLM | |
| 700 | 1 | |a Jood, Katarina |e verfasserin |4 aut | |
| 700 | 1 | |a Nordanstig, Annika |e verfasserin |4 aut | |
| 700 | 1 | |a Andersson, Tobias |e verfasserin |4 aut | |
| 700 | 1 | |a Nåtman, Jonatan |e verfasserin |4 aut | |
| 700 | 1 | |a Hjerpe, Per |e verfasserin |4 aut | |
| 700 | 1 | |a Rosengren, Annika |e verfasserin |4 aut | |
| 700 | 1 | |a Mourtzinis, Georgios |e verfasserin |4 aut | |
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