Non‐persistence in ischaemic stroke: Risk of recurrent vascular events

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Ischaemic stroke is one of the leading causes of death and disability worldwide.1 Patients suffering an ischaemic stroke have a risk of a recurrent vascular event (myocardial infarction (MI), stroke or vascular death), ranging from 9% to 18% each year.2 Therefore, it is essential to achieve adequate secondary prevention in these patients. Although the secondary prevention strategies are supposed to continue lifelong, medication use commonly declines over time.4 This may lead to stroke recurrence, disability and death.6
Prior studies have identified multiple factors causing discontinuation of medications, such as inadequate care transitions, side‐effects, poor patient‐provider communication, suboptimal patient resources and insurance coverage.7 Little is known concerning the long term prognosis of the consequences of medical non‐persistence in ischaemic stroke patients. There has been no study, linking the persistence of secondary prevention medication with the risk of a recurrent vascular event after an ischaemic stroke. In this study, we set out to examine the possible increase of recurrent vascular events after discontinuation of preventive medication in patients with an ischaemic stroke.

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