Antecedent Aspirin Use Is Associated with Less Severe Symptoms on Admission for Ischemic Stroke.
Antecedent Aspirin Use Is Associated with Less Severe Symptoms on Admission for Ischemic Stroke.
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DOI：
10.1016/j.jstrokecerebrovasdis.2016.06.032
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发表时间：
2016-10
期刊：
影响因子：
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通讯作者：
Sarah Nelson;L. Cloonan;Allison Kanakis;Kaitlin M. Fitzpatrick;K. Shideler;Adriana Perilla;K. Furie
中科院分区：
文献类型：
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作者：
Sarah Nelson;L. Cloonan;Allison Kanakis;Kaitlin M. Fitzpatrick;K. Shideler;Adriana Perilla;K. Furie
背景众所周知，阿司匹林可以降低中风风险；然而，其在降低缺血综合征严重程度方面的作用尚不清楚。我们试图调查既往使用阿司匹林与急性缺血性中风(AIS)患者卒中严重程度的关系。方法我们回顾分析了前瞻性收集的连续到我们中心就诊的AIS患者的数据库。临床特征(包括先期使用阿司匹林)、影像表现和实验室数据根据美国国立卫生研究院卒中评定量表(NIHSS)进行评估。用Logistic回归模型确定基线NIHSS的单变量和多变量预测因素。结果在610例入院的AIS患者中，有241例(39.5%)在卒中前服用了阿司匹林。单因素分析显示，既往使用阿司匹林(P= .0005)、房颤史(P<； .0001)、急性脑梗塞体积(P<； .0001)、初始收缩压(P= .041)、入院血糖水平(P= .0027)和卒中亚型(P<； .0001)与卒中严重程度相关。在多变量分析中，先前使用阿司匹林(P<； .0001)、房颤史(P<； .0002)、急性脑梗塞体积(P<； .0001)、收缩压(P= .038)和血糖水平(P= .0095)仍然是NIHSS的独立预测因素。虽然这种明显的保护关系的潜在生物学需要进一步研究，但中风高危患者可能会从常规使用阿司匹林中受益。
BackgroundAspirin is known to reduce stroke risk; however, its role in reducing severity of ischemic syndrome is not clear. We sought to investigate the relationship between antecedent aspirin use and stroke severity in patients presenting with acute ischemic stroke (AIS).MethodsWe retrospectively analyzed a prospectively collected database of consecutive AIS patients presenting to our center. Clinical characteristics (including antecedent aspirin use), imaging findings, and laboratory data were assessed in association with presenting stroke severity, as measured by the National Institutes of Health Stroke Scale (NIHSS). Logistic regression models were used to determine univariate and multivariate predictors of baseline NIHSS.ResultsOf the 610 AIS patients with admission brain magnetic resonance imaging available for volumetric analysis of acute infarct size, 241 (39.5%) used aspirin prior to stroke onset. Antecedent aspirin use (P= .0005), history of atrial fibrillation (P< .0001), acute infarct volume (P< .0001), initial systolic blood pressure (P= .041), admission glucose level (P= .0027), and stroke subtype (P< .0001) were associated with presenting stroke severity in univariate analysis. Antecedent aspirin use (P< .0001), history of atrial fibrillation (P< .0002), acute infarct volume (P< .0001), systolic blood pressure (P= .038), and glucose level (P= .0095) remained independent predictors of NIHSS in multivariable analysis.ConclusionsAntecedent aspirin use was independently associated with milder presenting stroke severity, even after accounting for acute infarct volume. While the underlying biology of this apparent protective relationship requires further study, patients at high risk of stroke may benefit from routine aspirin use.