Type

Journal Article

Authors

Peter J Kelly
David Williams
Sean Murphy
Eamon Dolan
Lorraine Kyne
Joseph Duggan
Gillian Horgan
Orla Sheehan
Aine Merwick
Michael Marnane
and 6 others

Subjects

Medicine & Nursing

Topics
low density secondary prevention dublin city atrial fibrillation primary prevention north dublin odds ratio year 1

Suboptimal lipid management before and after ischaemic stroke and TIA-the North Dublin Population Stroke Study. (2017)

Abstract Few population-based studies have assessed lipid adherence to international guidelines for primary and secondary prevention in stroke/transient ischaemic attack (TIA) patients. This study aims to evaluate adherence to lipid-lowering therapy (LLT) guidelines amongst patients with ischaemic stroke/TIA. Using hot and cold pursuit methods from multiple hospital/community sources, all stroke and TIA cases in North Dublin City were prospectively ascertained over a 1-year period. Adherence to National Cholesterol Education Programme (NCEP) III guidelines, before and after index ischaemic stroke/TIA, was assessed. Amongst 616 patients (428 ischaemic stroke, 188 TIA), total cholesterol was measured following the qualifying event in 76.5% (471/616) and low-density lipoprotein (LDL) in 60.1% (370/616). At initial stroke/TIA presentation, 54.1% (200/370) met NCEP III LDL goals. Compliance was associated with prior stroke (odds ratio [OR] 2.19, p = 0.02), diabetes (OR 1.91, p = 0.04), hypertension (OR 1.57, p = 0.03), atrial fibrillation (OR 1.78, p = 0.01), pre-event LLT (OR 2.85, p < 0.001) and higher individual LDL goal (p = 0.001). At stroke/TIA onset, 32.7% (195/596) was on LLT. Nonetheless, LDL exceeded individual NCEP goal in 29.2% (56/192); 21.6% (53/245) warranting LLT was not on treatment prior to stroke/TIA onset. After index stroke/TIA, 75.9% (422/556) was on LLT; 15.3% (30/196) meeting NCEP III criteria was not prescribed a statin as recommended. By 2 years, actuarial survival was 72.8% and 11.9% (59/497) experienced stroke recurrence. No association was observed between initial post-event target adherence and 2-year outcomes. In this population-based study, LLT recommended by international guidelines was under-used, before and after index stroke/TIA. Strategies to improve adherence are needed.
Collections Ireland -> University College Dublin -> PubMed

Full list of authors on original publication

Peter J Kelly, David Williams, Sean Murphy, Eamon Dolan, Lorraine Kyne, Joseph Duggan, Gillian Horgan, Orla Sheehan, Aine Merwick, Michael Marnane and 6 others

Experts in our system

1
Peter J Kelly
University College Dublin
Total Publications: 35
 
2
David Williams
Royal College of Surgeons in Ireland
Total Publications: 82
 
3
Sean Murphy
University College Dublin
Total Publications: 35
 
4
Eamon Dolan
IT Blanchardstown
Total Publications: 42
 
5
Lorraine Kyne
University College Dublin
Total Publications: 25
 
6
Joseph Duggan
University College Dublin
Total Publications: 11
 
7
Gillian Horgan
University College Dublin
Total Publications: 11
 
8
Orla C Sheehan
University College Dublin
Total Publications: 9
 
9
Aine Merwick
University College Dublin
Total Publications: 11
 
10
Michael Marnane
University College Dublin
Total Publications: 9