Abstract T MP107: Ischemic Strokes While on Aspirin: Initiation of Clopidogrel Is Better than Re-initiation of Aspirin for Prevention of Future Vascular Events

Background: It is currently unclear about what to do for the patient who has a breakthrough ischemic stroke while receiving aspirin, the so-called ‘aspirin treatment failure’. Objective: To compare the effectiveness of clopidogrel vs. aspirin for vascular risk reduction among ischemic stroke patients who were on aspirin treatment at the time of the index stroke. Methods: We analyzed the Taiwan National Health Insurance registry which comprises beneficiaries aged ≥ 18 years. Code ICD-9 was used to identify a primary hospitalization diagnosis of ischemic stroke among subjects encountered between 2003 and 2009, and continuously treated with aspirin ≥ 30 days before the index stroke. Follow-up was from time of the index stroke to admission for recurrent stroke or myocardial infarction; withdrawal from the registry; and last medical claim before 1/1/2011. Patients were categorized into 2 groups based on whether clopidogrel or aspirin was prescribed during follow-up period. Patients were excluded if their Medic...