The Use of Antiplatelet Agents for Secondary Prevention of Ischemic Stroke in U.S. Ambulatory Care Settings


Introduction. We examined stroke prevention with antiplatelet agents by U.S. nonfederal office physicians and hospital outpatient departments from 2005–2006.

Methods. The nationally representative dataset used a multistage (112 primary sampling units, physicians/ hospitals, patient medical records) random sample of 1,702 visits by patients 20 years or older with cerebrovascular disease (national estimate: 15.4 million annual visits). Dependent variable: use of antiplatelet agents for patients without contraindications. Independent variables: age, sex, race/ethnicity, payment, primary care provider, prior visits in last year, comorbidities. Logistic regression was used to investigate associations with recommended interventions.

Results. Antiplatelet agents were prescribed at 31.1% of visits. Positive predictors: seeing the patient’s primary care provider and having five or more comorbidities. Negative predictors: non-Hispanic Black race/ethnicity and having six or more prior visits in the last year.

Conclusion. Variations by visit characteristics suggest that improvement in using antiplatelet agents is possible, especially for non-Hispanic Black patients.