2025 THEPQR7 Optimization of Short-term Dual Antiplatelet Therapy for High-risk Cerebrovascular Events 

Measure Title: Optimization of Short-term Dual Antiplatelet Therapy for High-risk Cerebrovascular Events

Measure description: This measure assesses the proportion of adult patients who are prescribed short-term dual antiplatelet therapy upon discharge following a diagnosis of high-risk transient ischemic attack (TIA), minor non-embolic ischemic stroke, or intracranial large artery atherosclerosis. It encourages the use of evidence-based protocols to reduce the risk of recurrent stroke.

Denominator: All adult patients aged 18 years or older with a diagnosis of high-risk TIA (defined by an ABCD² score ? 4), minor ischemic stroke with an NIHSS score < 5, or intracranial large artery atherosclerosis during the measurement period.

Denominator Exceptions:

1. Patients for whom dual antiplatelet therapy was deemed inappropriate due to elevated risk for bleeding or poor prognosis where palliative care is the primary focus.
2. Patients who declined dual antiplatelet therapy after being informed of the risks and benefits.

Denominator Exclusions: 

1. Patients with contraindications to antiplatelet therapy such as active bleeding or a history of hemorrhagic stroke.
2. Patients who are on anticoagulant therapy for other medical conditions (e.g., atrial fibrillation).

Numerator:

Performance Met: Patients discharged on a short-term dual antiplatelet therapy.
Performance Not Met: Patients not discharged on a short-term dual antiplatelet therapy.

Numerator Exclusion: None