• Yannick Béjot, Marianne Zeller, Luc Lorgis, Odile Troisgros, Corine Aboa-Eboulé, Guy-Victor Osseby, Maurice Giroud, and Yves Cottin.
• Department of Neurology, Dijon Stroke Registry, EA4184, Medical School and University Hospital of Dijon, University of Burgundy, Dijon, France. ybejot@yahoo.fr
• J. Neurol. Neurosurg. Psychiatr.. 2013 Mar 1;84(3):348-53.

ObjectivesTo investigate the premorbid use of secondary prevention medications in patients with recurrent vascular events.DesignProspective, observational, population based study.SettingThe Dijon Stroke Registry and the registry of myocardial infarction of Dijon and Côte d'Or, France.PatientsAll patients with cerebral ischaemia (ischaemic stroke or transient ischaemic attacks) or coronary artery disease (CAD) and a history of vascular disease (cerebral ischaemia, CAD or peripheral arterial disease (PAD)) in Dijon, France from 2006 to 2010.Main Outcome MeasuresData on medical history and prior use of treatments were collected. Mutivariate analyses were performed to identify predictors of the use of medications.Results867 patients (614 cerebral ischaemia and 253 CAD) were recorded including 448 (51.7%) with a history of cerebral ischaemia only, 191 (22.0%) with a history of CAD only, 68 (7.8%) with a history of PAD only and 160 (18.5%) with a history of polyvascular disease. In these 867 patients, 57.3% were on antithrombotic therapy, 61.2% were treated with antihypertensive drugs, 32.9% received statins and only 23.6% were on an optimal regimen, defined as a combination of the three therapies. Compared with patients with previous CAD only, those with previous cerebral ischaemia only were less likely to be receiving each of these treatments or to receive an optimal regimen (OR=0.17, 95% CI 0.14 to 0.26, p<0.001).ConclusionsOur findings underline the fact that the underuse of secondary preventive therapies is common in patients with recurrent vascular events, especially those with previous cerebral ischaemia. This underuse could be targeted to reduce recurrent vascular events.

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