A retrospective claims cohort described postdischarge acquisition and persistence of P2Y12 inhibitors in 45 763 US adults after a first ischaemic stroke or TIA between July 2020 and December 2024. Fewer than one in five filled a prescription within 30 days, 94.9% of them clopidogrel, and among 5641 continuously enrolled initiators persistence at 90 days was 66.3% for clopidogrel and 78.3% for ticagrelor, falling to 50.5% and 59.6% at 180 days. Switching was uncommon overall but ran mostly from ticagrelor to clopidogrel (23.8% versus 1.7% in reverse), and claims do not capture over-the-counter aspirin.
Why it is interesting: Quantifies uptake and continuation of a secondary-prevention antiplatelet in routine claims, as a benchmark of acquisition and persistence and not of guideline adherence or comparative effectiveness.