Real-world assessment of anti-platelet therapies for recurrent stroke prevention in non-atrial fibrillation Japanese patients after recent ischemic stroke or transient ischemic attack

Abstract Background Stroke is one of the leading causes cardiovascular-related deaths and disability for adults in Japan more commonly seen among elderly. The risks developing a secondary stroke resulting permanent damage after incident ischemic (IS)/transient (TIA) are very high. It critical to understand treatment landscape prevention (SSP) unmet needs patients with prior IS/ TIA events. Purpose To evaluate antiplatelet therapy (APT) patterns SSP first hospitalization IS/TIA events Japanese population. Methods Japan's Medical Data Vision (MDV) from Q12011 Q22021 was used this study. MDV hospital-based claims database covering approximately 35.5 million individuals inpatient outpatient settings 438 hospitals. Adult an primary diagnosis during index period were identified. Patients require at least medical claim each quarter within 1 year before date ensure longitudinal analysis. Atrial fibrillation or on oral anticoagulant use excluded. Patients' characteristics, pattern duration evaluated. Results Of 18,948 study, mean age 75 years 36.7% female; 91.5% treated APT 8.5% untreated 90 days hospital discharge. Among 17,332 patients, 76.9% initiated single (SAPT), 22.7% dual (DAPT), <1% multiple (MAPT). most SAPT aspirin (ASA; 33.2%), clopidogrel (28.7%) cilostazol (14.8%) DAPT ASA+clopidogrel (15.1%), ASA+cilostazol (4.2%) cilostazol+clopidogrel (2.7%). median 320, 414 411 who ASA, cilostazol, respectively. ASA+clopidogrel, 298, 359 473 52.4% de-escalated (71% clopidogrel, 29% ASA; 20 days); 36.2% 19 (84% 16% ASA); lastly, 54.4% 35 (76% 24% clopidogrel). Two initial IS/TIA, 52%-56% discontinued treatments those previously receiving while 46%-57% treatment. Conclusion Majority risk received APT. Further analyses needed explore reasons early discontinuation, no use, outcomes Funding Acknowledgement Type funding sources: Private company. Main source(s): This study sponsored by Bristol Myers Squibb Janssen Research & Development, LLC. – Anonymised statistical purposes only