The following is a summary of “Trends in the Use of Medications for Secondary Ischemic Stroke Prevention in Denmark, 2005–2021,” published in the April 2024 issue of Neurology by Skajaa et al.
Researchers conducted a retrospective study to assess trends in the use of medications for preventing recurrent ischemic stroke after hospitalization, focusing on lipid-lowering, antihypertensive, glucose-lowering, oral anticoagulant, and antiplatelet medications (2005 to 2021).
They utilized nationwide registries in Denmark to pinpoint a group of patients who were discharged from the hospital after experiencing a first-time or recurrent ischemic stroke (N = 150,744). The 180-day likelihood of obtaining prescriptions for the mentioned medications post-discharge was determinpaed and categorized by calendar year. Factors were examined linked with medication utilization.
The results showed the utilization of lipid-lowering medications increased from 58.3% to 82.0% (2005 to 2021). Atorvastatin usage surged from 2.1% to 64.8%, while simvastatin usage dropped from 55.7% to 8.6%. Antihypertensive medication usage remained steady, hovering around 89%, with various classes used similarly. Glucose-lowering medication usage climbed from 71.5% in 2005 to 84.1% in 2021, primarily due to an uptick in metformin usage (from 28.0% to 59.5%). Usage of glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors saw continuous increases (from 1.7% to 17.5% and from 0.5% to 17.3%, respectively) between 2015 and 2021. Anticoagulant medication usage rose from 45.9% in 2005 to 87.0% in 2021, mainly driven by the increased adoption of direct oral anticoagulants starting around 2010 and a decline in warfarin usage. Antiplatelet usage remained consistently high, at about 95%. The trends remained consistent across various subgroups, though older patients (65 years and older), those with severe stroke, and individuals with neurologic and psychiatric comorbidities typically had lower overall medication usage.
Investigators concluded that the use of some preventive medications following ischemic stroke increased over time, but room for improvement remains, especially for specific patient groups.