Ongoing Use And Withdrawal Of Antithrombotic Medication For Medical Procedures In The Greater Cincinnati Population

Introduction: Withdrawal of antithrombotic medication for medical procedures is a potentially important cause of ischemic stroke (Broderick, Stroke, 2011). However, population estimates of how commonly persons in the general population withdraw from antithrombotic medication during a given year are not available. Methods: Telephone survey respondents were drawn from our biracial population of 1.3 million using random-digit dialing in 2011 to reflect the age, race, and gender distribution of stroke patients, based on an ongoing stroke incidence study in the same region. In addition to demographic and medical history questions, we also asked if they had stopped the medication on request of their physician for scheduled surgery or other procedure during the past 60 days. Results: There were a total of 2036 surveyed, 1959 self-identified as either black (544) or white (1415) race. 62% were on antithrombotic medication overall of which 7% were on an anticoagulant and 58% were on an antiplatelet medication and 4% on both (Table 1). Use of antithrombotic medication increased with advancing age (p<0.0001) and was more common in men (64%) than women (60%), p=0.09 and whites (64%) than blacks (55%), p=0.0003. Of those persons 75 years or older, 72% were taking an antithrombotic medication: an antiplatelet agent alone in 60%, anticoagulant alone in 6% and both in 6%. Of those using an antithrombotic medication, 10% indicated that they had stopped the medication in the past 60 days prior to interview. Of those that stopped the meds, 27/134 (20%) were on anticoagulants, and 101/1144 (9%) were on antiplatelet agents. Conclusions: Use of antithrombotic medication is widely prevalent in the population as is discontinuance of such medication for medical procedures, particularly warfarin. Withdrawal of anti-thrombotic medications for surgical procedures and diagnostic testing is a potential risk factor for ischemic stroke and is an important area for ongoing study.