Does Prior Aspirin Use Reduce Stroke Mortality?

Karlikaya, G.; Varlbas, Figen; Demirkaya, Mithat; Örken, Cihat; Tireli, Hülya

doi:10.1097/01.nrl.0000219637.83981.3c

Cited by 6 publications

(6 citation statements)

References 18 publications

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“…Our results are consistent with previous reports that focused on aspirin showing significant benefit for APT users compared with non-users for the early functional prognosis, while there was a non-significant protective effect of APT on 1-month mortality [5][6][7]. Nevertheless, this association was not proved by other studies [4,8,9].…”

Section: Discussionsupporting

confidence: 88%

“…As a consequence, APT is common in patients at the time of their first-ever stroke, with a prevalence ranging from 26% to 38% according to data from population-based registries [1][2][3]. Several previous studies pointed out the fact that prestroke APT, especially aspirin, could affect both the early functional and vital prognosis of stroke patients [4][5][6][7][8][9][10][11][12][13]. However, most of these studies were limited either by a small population size, a hospital-based setting, a lack of control for potential confounding factors in multivariate analyses, or no differentiation between stroke subtypes, which probably contributed to the conflicting results.…”

Section: Introductionmentioning

confidence: 99%

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Prestroke antiplatelet therapy and early prognosis in stroke patients: the Dijon Stroke Registry

Béjot

Aboa-Éboulé

Maistre

et al. 2012

Euro J of Neurology

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Prestroke antiplatelet therapy and early prognosis in stroke patients: the Dijon Stroke Registry

Béjot

Aboa-Éboulé

Maistre

et al. 2012

Euro J of Neurology

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“…The use of 75 mg ASA during the titration was set out to ensure that patients had a sufficient dosage of ASA during the 5-day titration phase as the combination tablet only contains 25 mg ASA and there is a consensus that at least 50 mg ASA daily is demanded for satisfactory stroke prevention [11]. …”

Section: Methodsmentioning

confidence: 99%

Dipyridamole-Associated Headache in Stroke Patients – Interindividual Differences?

Lökk¹

2009

Eur Neurol

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Background: Secondary pharmacological prevention of ischemic stroke or transient ischemic attack (TIA) is often provided with acetylsalicylic acid (ASA), dipyridamole (DP) or a combination of the two. A problem with DP is the occurrence of headache, sometimes leading to medication cessation. By using a titration regime of DP the incidence of headache gets lower. However, there are no studies on interindividual differences in the incidence of headache with regard to age, gender, localization of stroke and the number of days since stroke onset. Method: 20 stroke units in Sweden recruited newly diagnosed stroke and TIA patients in need for thrombocyte antiaggregating therapy. They were offered a titration regime of the combination ASA 25 mg + DP 200 mg once daily for 5 days followed by twice daily. Baseline characteristics of the patients were recorded and headache symptoms were filled in by each patient in a diary for 10 consecutive days. Rescue medication with paracetamol was optional. Results: 174 ischemic stroke patients with a mean age of 70.3 years, 63% men and 37% women, were recruited. Headache of any kind was reported in 70 patients (40.2%) and 37 (21.3%) assessed the headache as moderate/severe. Six patients stopped medication due to headache. A subsiding character of the headache was found with a mean of 3.1 days. Patients with TIA had a significantly higher risk of getting headache compared to manifest stroke, regardless of localization. There was a trend towards higher risk in younger age groups and females. No effect was seen on the number of days since stroke onset. Conclusion: DP is often associated with subsiding headache, however, with only few patients stopping medication due to headache. Being a younger female with a TIA seems to increase the risk of getting headache when having DP medication. Careful and adequate information about the possibly occurring headache should be given to patients prescribed a DP medication in order to increase compliance and optimize the pharmacological secondary stroke prevention.

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“…Our results indicate that heart dysfunction is not an independent predictor of all-cause mortality during long-term follow up in this cohort. Instead, we found that higher age, smoking, and pre-stroke myocardial infarction and none use of post-stroke aspirin [30-32] are independent predictors of mortality in patients with acute ischemic stroke or TIA, without atrial fibrillation. Lip et al [33] found that previous stroke/TIA was a predictor of mortality and of the composite end-point of stroke together with mortality in heart failure patients without atrial fibrillation, especially during the first 30 days following initial diagnosis of heart failure.…”

Section: Discussionmentioning

confidence: 78%

Heart dysfunction in patients with acute ischemic stroke or TIA does not predict all-cause mortality at long-term follow-up

Holmström

Hjalmarsson

et al. 2013

BMC Neurol

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BackgroundDespite heart failure being a substantial risk factor for stroke, few studies have evaluated the predictive value of heart dysfunction for all-cause mortality in patients with acute ischemic stroke, in particular in the elderly. The aim of this study was to investigate whether impaired heart function in elderly patients can predict all-cause mortality after acute ischemic stroke or transient ischemic attack (TIA).MethodsA prospective long-term follow-up analysis was performed on a hospital cohort consisting of n = 132 patients with mean age 73 ± 9 years, presenting with acute ischemic stroke or transient ischemic attack, without atrial fibrillation. All patients were examined by echocardiography during the hospital stay. Data about all-cause mortality were collected at the end of the follow-up period. The mean follow-up period was 56 ± 22 months.ResultsIn this cohort, 58% of patients with acute ischemic stroke or TIA had heart dysfunction. Survival analysis showed that heart dysfunction did not predict all-cause mortality in this cohort. Furthermore, in multivariate regression analysis age (HR 5.401, Cl 1.97-14.78, p < 0.01), smoking (HR 3.181, Cl 1.36-7.47, p < 0.01), myocardial infarction (HR 2.826, Cl 1.17-6.83, p < 0.05) were independent predictors of all-cause mortality.ConclusionIn this population with acute ischemic stroke or TIA and without non-valvular atrial fibrillation, impaired heart function does not seem to be a significant predictor of all-cause mortality at long-term follow-up.

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Does Prior Aspirin Use Reduce Stroke Mortality?

Abstract: Daily low dose (100-300 mg) aspirin has a protective effect in reducing the risk of early death in stroke.

Cited by 6 publications

References 18 publications

Prestroke antiplatelet therapy and early prognosis in stroke patients: the Dijon Stroke Registry

Prestroke antiplatelet therapy and early prognosis in stroke patients: the Dijon Stroke Registry

Dipyridamole-Associated Headache in Stroke Patients – Interindividual Differences?

Heart dysfunction in patients with acute ischemic stroke or TIA does not predict all-cause mortality at long-term follow-up

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