Key result
Ischemic stroke antiplatelet prescriptions rise ~12%, with aspirin remaining dominant while newer agents grow rapidly.
Why the study?
The current status and trends of antiplatelet medication use among ischemic stroke patients in China needed to be analyzed.
Cross-Sectional (n=1,505,850)
Yes
p-value: p=0.024
Aspirin remains the most widely used and cost-effective antiplatelet for ischemic stroke in China, though novel agents like ticagrelor and indobufen are rapidly growing despite significant regional and economic variations.
Prescription trends show shifting antiplatelet use in China; observational data leaves open drivers of change and outcome associations.
To analyze the current status and trends of antiplatelet medication use among ischemic stroke (IS) patients in China. This cross-sectional study utilized data from the China Hospital Prescription Analysis Database (2019-2024), analyzing 1,505,850 prescriptions. Mann-Kendall tests were employed to analyze the trends of prescriptions and cost, while log-linear models assessed changes in medication proportions. Defined daily cost (DDC) was calculated to evaluate economic differences. Among 1,505,850 prescriptions analyzed, 63.5% were for male patients, and 64.6% were for patients aged 65 and older. The patients median age of the prescriptions were 69 years (IQR: 61-78).Total antiplatelet prescriptions increased significantly from 300,573 in 2019 to 336,142 in 2024 (P = 0.024). Aspirin remained predominant (52.7%), while clopidogrel use declined significantly (46.6% to 40.9%, P = 0.002). Ticagrelor and indobufen showed rapid growth (both P < 0.001). Significant economic variations were observed: aspirin had the lowest DDC (¥0.57/DDD), while clopidogrel (¥3.60/DDD) and ticagrelor (¥6.61/DDD) decreased post-national centralized volume-based procurement policy (P < 0.001). Regional disparities were notable, with Zhengzhou (P < 0.001) and Hangzhou (P = 0.008) showing the fastest growth, while Tianjin (P < 0.001) and Shanghai (P = 0.003) declined significantly. Cilostazol demonstrated 104% regional DDC variation (Shenyang ¥16.96/DDD vs. Harbin ¥8.29/DDD). Antiplatelet prescription counts in Chinese IS patients increased in the past five years, with aspirin remaining the most widely used and cost-effective option. The treatment landscape shows "traditional drug dominance with new drug growth", marked by significant economic and regional variations, necessitating guideline-aligned and policy-informed optimization of medication strategies.
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Wu et al. (2025) conducted a cross-sectional in Ischemic stroke (n=1,505,850). Antiplatelet medications was evaluated on Annual total antiplatelet prescription counts (p=0.024). Total antiplatelet prescriptions for Chinese ischemic stroke patients increased significantly from 300,573 in 2019 to 336,142 in 2024, with aspirin remaining the predominant choice (52.7%) while clopidogrel use declined and newer agents like ticagrelor and indobufen showed rapid growth.
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