I
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rna
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l J
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urna
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ea
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(
I
J
P
H
S)
Vo
l.
5
,
No
.
3
,
Sep
tem
b
er
201
6
,
p
p
.
2
5
2
~
2
5
6
I
SS
N:
2252
-
8806
252
Jou
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The Use
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pertensiv
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Antiplatel
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d
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w
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:
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g
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s
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s
p
italiz
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Stro
k
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Co
p
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rig
h
t
©
2
0
1
6
In
stit
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te o
f
A
d
v
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n
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d
E
n
g
i
n
e
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rin
g
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S
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e
.
Al
l
rig
h
ts
re
se
rv
e
d
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Ak
r
o
m
,
Dep
ar
t
m
en
t o
f
P
h
ar
m
ac
o
lo
g
y
an
d
C
li
n
ical
P
h
ar
m
ac
y
,
Ah
m
ad
Dah
la
n
U
n
iv
er
s
it
y
,
Stre
et
P
r
o
f
.
Dr
.
So
ep
o
m
o
,
J
an
t
u
r
an
,
U
m
b
u
l
h
ar
j
o
,
Yo
g
y
a
k
ar
ta
.
I
n
d
o
n
esia
.
E
m
ail:
a
k
m
aa
_
u
ad
@
y
a
h
o
o
.
co
.
id
1.
I
NT
RO
D
UCT
I
O
N
Dec
is
io
n
d
r
u
g
u
s
e
al
w
a
y
s
co
n
tain
s
t
h
e
co
n
s
id
er
atio
n
o
f
b
en
ef
its
a
n
d
r
is
k
s
.
P
atien
ts
w
h
o
r
ec
eiv
ed
th
e
d
r
u
g
at
r
is
k
o
f
ex
p
er
ie
n
ci
n
g
d
r
u
g
-
r
elate
d
p
r
o
b
le
m
s
.
T
h
e
co
m
p
lex
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t
y
o
f
th
e
d
is
ea
s
e
an
d
d
r
u
g
u
s
e,
as
w
ell
a
s
h
ig
h
l
y
i
n
d
iv
id
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al
p
atien
t r
esp
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s
e
i
n
cr
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s
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n
g
e
m
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g
e
n
ce
o
f
d
r
u
g
-
r
elate
d
p
r
o
b
lem
s
[
1
]
.
T
h
e
g
o
al
o
f
th
er
ap
y
w
it
h
m
ed
icatio
n
is
th
e
ac
h
iev
e
m
e
n
t
o
f
th
er
ap
eu
tic
o
u
tco
m
e,
n
a
m
el
y
i
m
p
r
o
v
in
g
th
e
q
u
alit
y
o
f
li
f
e
o
f
p
atie
n
ts
w
it
h
m
i
n
i
m
al
r
is
k
.
I
n
ea
ch
th
er
e
is
a
r
i
s
k
o
f
d
r
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g
u
s
e,
w
h
e
th
er
k
n
o
w
n
o
r
n
o
t,
ca
lled
d
r
u
g
m
is
ad
v
en
tu
r
e,
wh
ich
in
c
lu
d
ed
ad
v
er
s
e
d
r
u
g
r
ea
ctio
n
s
a
n
d
m
ed
icatio
n
er
r
o
r
s
.
A
d
v
er
s
e
d
r
u
g
r
ea
ctio
n
s
ar
e
m
o
r
e
a
f
f
ec
ted
b
y
t
h
e
co
n
d
itio
n
o
f
t
h
e
p
atie
n
t
s
,
w
h
er
ea
s
m
ed
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n
er
r
o
r
s
o
cc
u
r
d
u
e
to
h
u
m
a
n
er
r
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r
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r
w
ea
k
n
ess
o
f
th
e
e
x
is
ti
n
g
s
y
s
te
m
[
2
]
.
On
e
o
f
th
e
d
is
ea
s
es
w
h
ic
h
i
s
a
m
ed
ical
e
m
er
g
e
n
c
y
th
at
ca
n
ca
u
s
e
p
h
y
s
ical
a
n
d
m
e
n
tal
d
i
s
ab
ilit
ies,
an
d
ca
n
ca
u
s
e
s
u
d
d
en
d
ea
t
h
was
a
s
tr
o
k
e.
Stro
k
e
is
a
ce
r
eb
r
o
v
ascu
lar
d
is
ea
s
e
is
th
e
lead
in
g
ca
u
s
e
o
f
d
ea
t
h
i
s
o
f
ten
t
h
e
ca
s
e
in
I
n
d
o
n
es
ia.
Ser
v
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ce
n
ter
s
in
n
eu
r
o
lo
g
y
I
n
d
o
n
esia
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u
m
b
er
o
f
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eo
p
le
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cir
cu
lato
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o
r
d
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s
o
f
th
e
b
r
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(
GP
DO)
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is
th
e
f
ir
s
t o
f
all
p
atie
n
t a
d
m
is
s
io
n
s
[
3
]
,
[
4
]
.
T
h
e
p
r
ev
alen
ce
o
f
s
tr
o
k
e
i
n
I
n
d
o
n
esia
a
m
o
u
n
ted
to
1
2
.
1
d
ea
t
h
s
p
er
1
0
0
0
p
o
p
u
latio
n
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d
w
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a
s
b
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d
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s
ed
b
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h
p
er
s
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el
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I
J
P
HS
I
SS
N:
2252
-
8806
Th
e
Use o
f A
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tih
yp
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s
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a
n
d
A
n
tip
la
telet
Dru
g
s
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Ho
s
p
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l S
tr
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P
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(
A
n
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P
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253
w
a
s
7
d
ea
th
s
p
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.
Stro
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s
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al
m
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t
all
h
o
s
p
itals
in
I
n
d
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n
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n
a
m
el
y
1
4
.
5
p
er
ce
n
t
[
5
]
.
2.
RE
S
E
ARCH
M
E
T
H
O
D
2
.
1
.
Resea
rc
h t
o
o
l
T
h
e
to
o
l u
s
ed
f
o
r
r
esear
ch
in
t
h
e
f
o
r
m
o
f
C
a
s
e
R
ec
o
r
d
Fo
r
m
(
C
R
F).
2
.
2
.
M
a
t
er
ia
ls
re
s
ea
rc
h
Ma
ter
ials
u
s
ed
in
t
h
e
s
t
u
d
y
ar
e
p
r
im
ar
y
d
ata
a
n
d
s
ec
o
n
d
ar
y
d
ata.
T
h
e
p
r
i
m
ar
y
d
ata
co
m
e
s
f
r
o
m
in
ter
v
ie
w
s
to
p
atien
ts
w
h
ile
s
ec
o
n
d
ar
y
d
ata
d
er
iv
ed
f
r
o
m
t
h
e
p
atien
t
'
s
m
ed
ical
r
ec
o
r
d
.
I
n
f
o
r
m
atio
n
o
b
tain
ed
f
r
o
m
b
o
th
p
r
i
m
ar
y
d
ata
an
d
s
ec
o
n
d
ar
y
d
ata
is
th
e
n
w
r
itte
n
in
th
e
C
a
s
e
R
ec
o
r
d
Fo
r
m
(
C
R
F),
w
h
ich
h
as
b
ee
n
cr
ea
ted
b
y
r
esear
ch
er
s
a
n
d
h
as
b
ee
n
i
n
le
g
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m
ate
r
ig
h
t
b
y
t
h
e
et
h
ic
s
co
m
m
i
ttee
o
f
t
h
e
U
n
iv
er
s
it
y
o
f
Ah
m
ad
Dah
la
n
.
2
.
3
.
Sta
g
e
o
f
Resea
rc
h
2
.
3
.
1
.
Study
des
ig
n
T
h
is
i
s
a
d
escr
ip
tiv
e
o
b
s
er
v
atio
n
al
r
esear
c
h
.
Data
w
er
e
co
llected
d
ata
co
llectio
n
w
a
s
d
o
n
e
p
r
o
s
p
ec
tiv
el
y
w
it
h
a
s
u
r
v
e
y
o
f
s
tr
o
k
e
p
atie
n
t
s
in
i
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O
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1)
P
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th
is
s
tu
d
y
w
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e
all
p
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ts
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ia
g
n
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ed
s
tr
o
k
e
w
it
h
o
r
w
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th
o
u
t
co
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o
r
b
id
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,
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o
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e
h
o
s
p
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th
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s
A
l
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I
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s
a
n
an
d
al
-
A'
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aa
f
at
P
KU
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h
a
m
m
ad
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y
ah
Ho
s
p
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n
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an
t
u
l
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m
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2)
Stro
k
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t
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(
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[
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,
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a)
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Dr
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3.
RE
SU
L
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3
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1
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G
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ha
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6
254
T
ab
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1
.
Gen
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C
h
ar
ac
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ti
cs o
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P
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I
n
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atie
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t W
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P
KU
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m
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20
32
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44
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6
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2
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Cl
ini
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l c
ha
ra
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C
li
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ical
c
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ar
ac
ter
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n
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d
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e
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atie
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iv
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at
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o
s
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ital,
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h
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te
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s
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e,
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s
s
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s
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tio
n
MS
C
T
h
ea
d
,
R
P
D
Stro
k
e,
an
d
s
m
o
k
i
n
g
h
i
s
to
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y
ar
e
p
r
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ted
in
T
ab
le
2
.
T
ab
le
2
.
C
lin
ical
C
h
ar
ac
ter
is
ti
cs o
f
P
atien
ts
i
n
i
n
p
atien
t
w
ar
d
P
KU
Mu
h
a
m
m
ad
i
y
ah
Ho
s
p
i
tal
in
B
an
t
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l
C
h
a
r
a
c
t
e
r
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st
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c
s
F
r
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q
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e
n
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y
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e
r
c
e
n
t
a
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e
A
r
r
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v
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d
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n
<
4
h
o
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r
s
33
54
.
1
0
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28
45
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9
0
S
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21
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5
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St
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33
54
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1
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M
S
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T
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d
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s
28
45
.
9
0
No
33
54
.
1
0
R
P
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12
19
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7
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No
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80
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3
0
H
i
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3
4
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S
mo
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No
38
62
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3
0
F
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r
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r
20
32
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8
0
A
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tab
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2
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p
atien
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e
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o
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<4
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o
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r
s
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y
3
3
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5
4
.
1
%).
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tal
o
f
3
3
(
5
4
.
1
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f
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tr
o
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e
w
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n
o
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ie
d
.
A
to
tal
o
f
3
3
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5
4
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1
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d
id
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t
d
o
MSC
T
h
ea
d
.
Mo
s
t p
atien
ts
w
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th
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s
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y
o
f
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tr
o
k
e
b
y
4
9
(
8
0
.
3
%).
A
to
tal
o
f
3
8
(
6
2
.
3
%)
p
atien
ts
n
o
t t
o
s
m
o
k
e.
3
.
3
.
Drug
us
e
Descr
ip
tio
n
o
f
Dr
u
g
Use
i
n
th
e
i
n
p
atien
t
w
ar
d
P
KU
Mu
h
a
m
m
ad
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s
p
ital
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n
B
an
tu
l
ar
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p
r
esen
ted
in
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ab
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3
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B
ased
o
n
T
ab
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3
is
k
n
o
w
n
th
a
t
all
p
atien
t
s
d
id
n
o
t
r
ec
eiv
e
th
r
o
m
b
o
l
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h
o
w
e
v
er
,
all
p
atien
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ec
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a
n
e
u
r
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p
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e.
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s
t
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atie
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ts
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et
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r
u
g
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e
u
r
o
tr
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p
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ic
5
6
(
9
1
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8
%).
A
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t
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o
f
3
3
(
5
4
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p
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n
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h
y
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d
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s
.
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s
t
p
ati
en
ts
d
id
n
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t
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v
e
a
n
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n
l
y
1
7
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2
7
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p
atien
ts
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ec
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g
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n
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d
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s
.
W
h
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s
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atie
n
ts
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ei
v
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h
e
m
o
s
tat
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d
r
u
g
s
as
m
u
c
h
a
s
9
(
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4.
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.
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I
SS
N
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2
5
2
-
8806
I
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Sep
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201
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256
RE
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A
,
“
M
e
d
ica
ti
o
n
Err
o
rs
i
n
A
c
u
te
Ca
rd
io
v
a
sc
u
lar
a
n
d
St
ro
k
e
P
a
t
ien
ts
a
S
c
ien
ti
f
ic
S
tate
m
e
n
t
F
ro
m
th
e
Am
e
rica
n
He
a
rt
As
so
c
iatio
n
,
”
Circ
u
l
a
ti
o
n
,
v
o
l.
1
2
1
,
p
p
.
1
6
6
4
-
1
6
8
2
,
2
0
1
0
.
[2
]
L
.
T
.
Ko
h
n
,
J.
M
.
C
o
rrig
a
n
,
M
.
S
.
Do
n
a
l
d
so
n
,
“
Err
o
r
in
He
a
lt
h
Ca
re
:
A
L
e
a
d
in
g
Ca
u
se
o
f
De
a
th
a
n
d
In
j
u
ry
,”
in
L
.
T
.
K
o
h
n
,
“
T
o
Err
is
Hu
m
a
n
,
In
stit
u
te o
f
M
e
d
icin
e
,
”
Na
ti
o
n
a
l
A
c
a
d
e
m
y
P
re
ss
,
W
a
sh
in
g
to
n
D.C
.
,
p
p
.
26
-
4
7
,
2
0
0
0
.
[3
]
M
.
A
.
Hu
ss
a
in
,
A
.
A
l
M
a
m
u
n
,
S
.
A
.
P
e
ters
,
e
t
a
l.
,
“
T
h
e
Bu
r
d
e
n
o
f
Ca
rd
io
v
a
sc
u
lar
Dise
a
se
A
tt
rib
u
tab
leto
M
a
jo
r
M
o
d
if
iab
le Ri
sk
F
a
c
to
rs i
n
I
n
d
o
n
e
sia
,
”
J
Ep
id
e
mio
l
,
p
p
.
1
-
7
,
2
0
1
6
.
[4
]
M
in
istry
o
f
He
a
lt
h
Re
p
u
b
li
c
o
f
In
d
o
n
e
sia
, “
I
n
d
o
n
e
sia
He
a
lt
h
P
r
o
f
il
e
2
0
1
3
,”
Ja
k
a
rta,
In
d
o
n
e
sia
,
2
0
1
4
.
[5
]
T
h
e
Na
ti
o
n
a
l
In
stit
u
te
o
f
He
a
lt
h
Re
se
a
rc
h
a
n
d
De
v
e
lo
p
m
e
n
t
,
“
Re
su
lt
o
f
Na
ti
o
n
a
l
Ba
sic
H
e
a
lt
h
Re
se
a
rc
h
(RIS
KES
DA
S
2
0
0
7
)
,
M
in
istry
o
f
He
a
lt
h
,
Re
p
u
b
li
c
o
f
In
d
o
n
e
sia
,
Ja
k
a
rta
,
2
0
1
3
.
[6
]
G
.
L
io
n
e
l,
“
L
e
c
tu
re
No
tes
:
Ne
u
ro
lo
g
y
,
Ed
.
V
III
,
”
Ja
k
a
rta,
Erl
a
n
g
g
a
,
2
0
0
8
.
[7
]
M
in
istry
o
f
He
a
lt
h
Re
p
u
b
li
c
o
f
In
d
o
n
e
sia
,
“
S
tro
k
e
G
u
id
e
li
n
e
,”
M
i
n
istry
o
f
H
e
a
lt
h
,
Re
p
u
b
li
c
o
f
In
d
o
n
e
sia
,
Ja
k
a
rta
,
2
0
1
3
.
[8
]
T
h
e
Eu
ro
p
e
a
n
S
tr
o
k
e
Org
a
n
iza
ti
o
n
(ES
O)
Ex
e
c
u
ti
v
e
Co
m
m
it
te
e
a
n
d
t
h
e
ES
O
W
rit
i
n
g
Co
m
m
it
te
e
,
“
G
u
id
e
li
n
e
s
f
o
r
M
a
n
a
g
e
m
e
n
t
o
f
Isc
h
a
e
m
i
c
S
tro
k
e
a
n
d
T
ra
n
sie
n
t
Isc
h
a
e
m
ic
A
tt
a
c
k
,”
2
0
0
8
.
ww
w
.
e
so
stro
k
e
.
o
rg
.
[9
]
J.
P
o
tt
e
r,
A
.
M
istri
,
F.
Bro
d
ie,
e
t
a
l.
,
“
Co
n
tr
o
ll
i
n
g
H
y
p
e
rten
sio
n
a
n
d
Hy
p
o
ten
sio
n
Im
m
e
d
iate
l
y
P
o
s
t
S
tro
k
e
(CHH
IP
S
)
–
a
ra
n
d
o
m
ise
d
c
o
n
tr
o
ll
e
d
tri
a
l
,
”
He
a
l
th
T
e
c
h
n
o
lo
g
y
Asse
ss
me
n
t
,
v
ol
/i
ss
u
e
:
13
(
9
)
,
2
0
0
9
.
[1
0
]
P
ERDOS
S
I,
“
T
h
e
2
0
1
1
S
tr
o
k
e
Gu
id
e
li
n
e
,
”
In
d
o
n
e
sia
Ne
u
ro
lo
g
ist
Do
c
to
r
A
ss
o
c
iatio
n
,
Ja
k
a
rta
,
2
0
1
1
.
[1
1
]
G
.
M
a
n
c
ia
,
“
Eff
e
c
ts
o
f
In
ten
siv
e
Blo
o
d
P
re
ss
u
re
Co
n
tr
o
l
i
n
t
h
e
M
a
n
a
g
e
m
e
n
t
o
f
P
a
ti
e
n
ts
W
it
h
T
y
p
e
2
Dia
b
e
tes
M
e
ll
it
u
s
i
n
t
h
e
A
c
ti
o
n
t
o
Co
n
tr
o
l
Ca
rd
io
v
a
sc
u
lar
Risk
in
Dia
b
e
tes
(A
CCOR
D)
T
rial
,
”
Circ
u
la
ti
o
n
,
v
o
l.
1
2
2
,
p
p
.
847
-
8
4
9
,
2
0
1
0
.
[1
2
]
D.
Y.
Hu
a
n
g
,
W
.
G
.
Ei
se
rt,
“
Ch
a
n
c
e
T
ri
a
l
Earl
y
S
h
o
rt
-
T
e
r
m
Du
a
l
A
n
ti
p
late
let
T
r
e
a
t
m
e
n
t
f
o
r
S
tro
k
e
P
re
v
e
n
ti
o
n
,
”
S
tro
k
e
,
v
o
l.
44
,
p
p
.
3
6
2
3
-
3
6
2
4
,
2
0
1
3
.
[1
3
]
Dip
iro
,
et
al
.
,
“
P
h
a
rm
a
c
o
th
e
ra
p
y
A
P
a
th
o
p
y
sio
lo
g
ic
A
p
p
ro
a
c
h
,
”
M
c
–
G
ra
w
Hill
,
Ne
w
Yo
rk
,
v
o
l.
4
5
2
,
p
p
.
4
5
6
-
4
5
9
,
2
0
0
5
.
[1
4
]
K.
Kik
u
c
h
i
,
H.
Uc
h
ik
a
d
o
,
M.
M
o
rio
k
a
,
e
t
a
l.
,
“
Cli
n
ica
l
Ne
u
ro
p
r
o
tec
ti
v
e
Dru
g
s
f
o
r
T
re
a
t
m
e
n
t
a
n
d
P
re
v
e
n
ti
o
n
o
f
S
tro
k
e
,
”
In
t.
J
.
M
o
l.
S
c
i
,
v
o
l
.
1
3
,
p
p
.
7
7
3
9
-
7
7
6
1
,
2
0
1
2
.
d
o
i:
1
0
.
3
3
9
0
/i
jm
s1
3
0
6
7
7
3
9
.
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