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CV conditions and treatments

Session: Poster Session A

(171) Factors Associated with Reinitiation and Subsequent Discontinuation of Antiplatelet Medication in Patients with Peripheral Arterial Disease

Monday, August 26, 2024
8:00 AM – 6:00 PM CEST
Location: Convention Hall II

    Presenting Author(s)

  • Martin Wawruch, Prof, MD, PhD

    Professor, Head of the Institute
    Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, Slovakia

    • Co-Author(s)

  • MP

    Miriam Petrova

    Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava
    Bratislava, Slovakia

  • JM

    Jan Murin

    1st Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia

  • TT

    Tomas Tesar

    Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia

  • EA

    Emma Aarnio

    School of Pharmacy, University of Eastern Finland, Kuopio, Finland

Background: Long-term persistence with antiplatelet medication is an essential precondition of successful secondary prevention in patients with peripheral arterial disease (PAD).

Objectives: The aims of our study were: a) to determine the proportion of non-persistent patients who reinitiated antiplatelet treatment; b) to identify patients who discontinued antiplatelet therapy after reinitiation; and c) to determine patient- and medication-related characteristics associated with reinitiation and subsequent discontinuation.

Methods: Our retrospective cohort study was conducted on a sample of 5158 patients who became non-persistent with antiplatelet medications and in whom PAD was newly diagnosed in 2012. Subsequent discontinuation was analysed in 3470 reinitiating patients. Discontinuation was defined according to a treatment gap of 6 months without antiplatelet medication prescription. The database of the General Health Insurance Company represented a source of data for our analyses. Factors associated with reinitiation and subsequent discontinuation were identified using the Cox regression with time-dependent covariates.

Results: Reinitiation was recorded in 3470 (67.3%) of 5158 non-persistent patients. Among these reinitiators, 1981 (57.1%) patients discontinued antiplatelet medication again. Ischemic stroke and myocardial infarction during the period of non-persistence and bronchial asthma / chronic obstructive pulmonary disease were associated with an increased probability of reinitiation. University education was associated with discontinuation among reinitiators.

Conclusions: Factors associated with reinitiation and subsequent discontinuation make it possible to identify PAD patients with stop-starting behaviour.

This research was funded by a grant from the Scientific Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic VEGA 1/0024/21.