{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:50:24Z","timestamp":1792785024509,"version":"4.5.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Study on Key Knowledge Points for Enhancing Residents\u2019 Medication Literacy","award":["ZDC202404"],"award-info":[{"award-number":["ZDC202404"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    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\u20132024), analyzing 1,505,850 prescriptions. Mann\u2013Kendall 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\u00a0years (IQR: 61\u201378).Total antiplatelet prescriptions increased significantly from 300,573 in 2019 to 336,142 in 2024 (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.024). Aspirin remained predominant (52.7%), while clopidogrel use declined significantly (46.6% to 40.9%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.002). Ticagrelor and indobufen showed rapid growth (both\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). Significant economic variations were observed: aspirin had the lowest DDC (\u00a50.57\/DDD), while clopidogrel (\u00a53.60\/DDD) and ticagrelor (\u00a56.61\/DDD) decreased post-national centralized volume-based procurement policy (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). Regional disparities were notable, with Zhengzhou (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001) and Hangzhou (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.008) showing the fastest growth, while Tianjin (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001) and Shanghai (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.003) declined significantly. Cilostazol demonstrated 104% regional DDC variation (Shenyang \u00a516.96\/DDD vs. Harbin \u00a58.29\/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 \u201ctraditional drug dominance with new drug growth\u201d, marked by significant economic and regional variations, necessitating guideline-aligned and policy-informed optimization of medication strategies.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-22390-8","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T12:58:55Z","timestamp":1762347535000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Antiplatelet therapy trends in Chinese ischemic stroke patients 2019\u20132024"],"prefix":"10.1038","volume":"15","author":[{"given":"Mingfen","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailun","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aning","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"22390_CR1","doi-asserted-by":"publisher","unstructured":"Chinese Society of Neurology & Chinese Society of Neurology Cerebrovascular Disease Group. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2023. Chin. J. Neurol. 57(6), 523\u2013559. https:\/\/doi.org\/10.3760\/cma.j.cn113694-20240410-00221 (2024)","DOI":"10.3760\/cma.j.cn113694-20240410-00221"},{"issue":"12","key":"22390_CR2","doi-asserted-by":"publisher","first-page":"e344","DOI":"10.1161\/STR.0000000000000211","volume":"50","author":"WJ Powers","year":"2019","unstructured":"Powers, W. J. et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare professionals from the American heart association\/American stroke association. Stroke 50(12), e344\u2013e418. https:\/\/doi.org\/10.1161\/STR.0000000000000211 (2019).","journal-title":"Stroke"},{"issue":"3","key":"22390_CR3","doi-asserted-by":"publisher","first-page":"I","DOI":"10.1177\/23969873221100032","volume":"7","author":"J Dawson","year":"2022","unstructured":"Dawson, J. et al. European stroke organisation (ESO) guideline on pharmacological interventions for long-term secondary prevention after ischaemic stroke or transient ischaemic attack. Eur. Stroke J. 7(3), I\u2013II. https:\/\/doi.org\/10.1177\/23969873221100032 (2022).","journal-title":"Eur. Stroke J."},{"issue":"1","key":"22390_CR4","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s40263-024-01127-7","volume":"39","author":"SR Ahmed","year":"2025","unstructured":"Ahmed, S. R. et al. Tica-clop study: ticagrelor versus clopidogrel in acute moderate and moderate-to-severe ischemic stroke, a randomized controlled multi-center trial. CNS Drugs 39(1), 81\u201393. https:\/\/doi.org\/10.1007\/s40263-024-01127-7 (2025).","journal-title":"CNS Drugs"},{"issue":"3","key":"22390_CR5","doi-asserted-by":"publisher","first-page":"e207809","DOI":"10.1212\/WNL.0000000000207809","volume":"102","author":"X Meng","year":"2024","unstructured":"Meng, X. et al. One-year outcomes of early therapy with ticagrelor vs clopidogrel in CYP2C19 loss-of-function carriers with stroke or TIA trial. Neurology 102(3), e207809. https:\/\/doi.org\/10.1212\/WNL.0000000000207809 (2024).","journal-title":"Neurology"},{"issue":"1","key":"22390_CR6","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1186\/s12883-024-03585-4","volume":"24","author":"X Liu","year":"2024","unstructured":"Liu, X. et al. Clopidogrel with indobufen or aspirin in minor ischemic stroke or high-risk transient ischemic attack: A randomized controlled clinical study. BMC Neurol. 24(1), 81. https:\/\/doi.org\/10.1186\/s12883-024-03585-4 (2024).","journal-title":"BMC Neurol."},{"issue":"1","key":"22390_CR7","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1186\/s12916-024-03374-3","volume":"22","author":"C Dai","year":"2024","unstructured":"Dai, C. et al. Real-world performance of indobufen versus aspirin after percutaneous coronary intervention: Insights from the aspiration registry. BMC Med. 22(1), 148. https:\/\/doi.org\/10.1186\/s12916-024-03374-3 (2024).","journal-title":"BMC Med."},{"key":"22390_CR8","doi-asserted-by":"publisher","first-page":"942377","DOI":"10.3389\/fpubh.2022.942377","volume":"10","author":"Z Yu","year":"2022","unstructured":"Yu, Z. et al. Antiviral treatment in outpatients with herps zoster in six major areas of China, 2010\u20132019. Front. Public Health 10, 942377. https:\/\/doi.org\/10.3389\/fpubh.2022.942377 (2022).","journal-title":"Front. Public Health"},{"issue":"5","key":"22390_CR9","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1016\/j.jacc.2024.10.121","volume":"85","author":"P Joseph","year":"2025","unstructured":"Joseph, P. et al. Secondary prevention medications in 17 countries grouped by income level (pure): A prospective cohort study. J. Am. Coll. Cardiol. 85(5), 436\u2013447. https:\/\/doi.org\/10.1016\/j.jacc.2024.10.121 (2025).","journal-title":"J. Am. Coll. Cardiol."},{"issue":"8","key":"22390_CR10","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1001\/jama.2023.12905","volume":"330","author":"S Yoo","year":"2023","unstructured":"Yoo, S. et al. Aspirin for secondary prevention of cardiovascular disease in 51 low-, middle-, and high-income countries. JAMA 330(8), 715\u2013724. https:\/\/doi.org\/10.1001\/jama.2023.12905 (2023).","journal-title":"JAMA"},{"issue":"4","key":"22390_CR11","doi-asserted-by":"publisher","first-page":"e1003582","DOI":"10.1371\/journal.pmed.1003582","volume":"18","author":"LL Yan","year":"2021","unstructured":"Yan, L. L. et al. Effectiveness of a primary care-based integrated mobile health intervention for stroke management in rural China (SINEMA): A cluster-randomized controlled trial. PLoS Med. 18(4), e1003582. https:\/\/doi.org\/10.1371\/journal.pmed.1003582 (2021).","journal-title":"PLoS Med."},{"issue":"10","key":"22390_CR12","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1161\/CIRCULATIONAHA.124.069651","volume":"150","author":"M Mulder","year":"2024","unstructured":"Mulder, M., Cras, T., Shay, J., Dippel, D. & Burke, J. Comparison of American and European guideline recommendations for diagnostic workup and secondary prevention of ischemic stroke and transient ischemic attack. Circulation 150(10), 806\u2013815. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.124.069651 (2024).","journal-title":"Circulation"},{"key":"22390_CR13","doi-asserted-by":"publisher","unstructured":"Chinese Medical Association, Chinese Medical Association Publishing House, Chinese Society of General Practice, Editorial Board of Chinese Journal of General Practitioners of Chinese Medical Association & Expert Group of Guidelines for Primary Care of Nervous System Disease. Guidelines for primary care management of ischemic stroke (practical edition 2021). Chin. J. Gen. Pract. 20(9), 947\u2013958. https:\/\/doi.org\/10.3760\/cma.j.cn114798-20210804-00591 (2021).","DOI":"10.3760\/cma.j.cn114798-20210804-00591"},{"issue":"5","key":"22390_CR14","doi-asserted-by":"publisher","first-page":"240","DOI":"10.3969\/j.issn.1004-8812.2021.05.001","volume":"29","author":"H Y","year":"2021","unstructured":"Y, H. et al. Expert consensus on diagnosis and management of intolerance and low responsiveness to common oral antiplatelet agents. Chin. J. Interv. Cardiol. 29(5), 240\u2013249. https:\/\/doi.org\/10.3969\/j.issn.1004-8812.2021.05.001 (2021).","journal-title":"Chin. J. Interv. Cardiol."},{"issue":"3","key":"22390_CR15","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1056\/NEJMoa1916870","volume":"383","author":"SC Johnston","year":"2020","unstructured":"Johnston, S. C. et al. Ticagrelor and aspirin or aspirin alone in acute ischemic stroke or TIA. N. Engl. J. Med. 383(3), 207\u2013217. https:\/\/doi.org\/10.1056\/NEJMoa1916870 (2020).","journal-title":"N. Engl. J. Med."},{"issue":"9","key":"22390_CR16","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1001\/jamaneurol.2021.2440","volume":"78","author":"Y Wang","year":"2021","unstructured":"Wang, Y. et al. Efficacy and safety of ticagrelor and aspirin in patients with moderate ischemic stroke: An exploratory analysis of the THALES randomized clinical trial. JAMA Neurol. 78(9), 1091\u20131098. https:\/\/doi.org\/10.1001\/jamaneurol.2021.2440 (2021).","journal-title":"JAMA Neurol."},{"issue":"2","key":"22390_CR17","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1111\/bcp.15921","volume":"90","author":"Z Zhang","year":"2024","unstructured":"Zhang, Z., Bao, Y., Gu, Y., Zhang, M. & Li, X. Cost-effectiveness analysis of CYP2C19 genotype-guided antiplatelet therapy for patients with acute minor ischemic stroke and high-risk transient ischemic attack in China. Br. J. Clin. Pharmacol. 90(2), 483\u2013492. https:\/\/doi.org\/10.1111\/bcp.15921 (2024).","journal-title":"Br. J. Clin. Pharmacol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22390-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22390-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22390-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T12:59:01Z","timestamp":1762347541000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22390-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["22390"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-22390-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]},"assertion":[{"value":"13 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"38731"}}