ABSTRACT NUMBER: ESOC2026LB182 EVALUATION OF ANTITHROMBOTIC THERAPY FOLLOWING FIRST PRESENTATION OF STROKE. A POPULATION-LEVEL OBSERVATIONAL COHORT STUDY IN WALES.

Abstract Background and aims To assess the provision of antithrombotic therapy in the year following a first diagnosis of stroke, using a Wales wide databank. Methods A retrospective observational cohort study using routine electronic health records of 52,400 incident stroke patients in Wales between 2010 and 2023 with at least one year follow-up. Stroke survivors were classified as ischaemic, haemorrhagic or unspecified and were assessed being prescribed either antiplatelet (AP), antitcoagulant (AC), both or none. A further analysis in patients with atrial fibrillation (AF) was also conducted. Results In ischaemic stroke 67.5% were taking AP, 18.4% AC, 7.9% both and 6.1% none. In haemorrhagic stroke 19.2% AP, 10.4% AC, 2.8% Both and 68% none and in unspecified stroke 69.8% AP, 12.8% AT, 5.8% both and 11.6% none. In people with AF and ischaemic stroke 12.1% were taking AP, 68% AC, 16.6% both and 3.3% none. In AF and haemorrhagic stroke 13.1% AP, 44.1% AC, 9.2% both and 34.6% none and in AF and unspecified stroke 17.4% AP, 62.88% AC, 15.1% Both and 4.7% none. Conclusions Approximately two thirds of ischaemic stroke survivors with and without AF appeared to be on the appropriate antithrombotic management. Antithrombotic management was far more varied in people with haemorrhagic or unspecified stroke. These data highlight both the benefits to be gained from better targeting of treatment, identified suboptimum prescribing of treatments proven to improve outcomes in post-stroke management. Conflict of interest