Does prior aspirin use reduce stroke mortality?
Does prior aspirin use reduce stroke mortality?
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DOI：
10.1097/01.nrl.0000219637.83981.3c
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发表时间：
2006-09-01
期刊：
影响因子：
1.2
通讯作者：
Tireli, Huelya
中科院分区：
文献类型：
--
作者：
Karlikaya, Geysu;Varlibas, Figen;Tireli, Huelya
背景：全世界有数百万人定期服用阿司匹林，但其在确定中风严重程度方面的价值仍不清楚。已经指出，既往使用阿司匹林可能通过减小纤维蛋白-血小板栓塞的大小或改善微循环中发生的血小板高聚集性来降低缺血性卒中的严重程度。然而，只有少数大型研究关注卒中患者的早期预后，包括缺血性卒中和既往接受阿司匹林治疗的原发性脑出血患者。我们回顾性分析了在土耳其伊斯坦布尔Haydarpasa Numune教育和研究医院第二神经病学诊所住院的2509例连续卒中患者的病历，在1993-2003年期间。我们比较了既往使用阿司匹林患者与未使用阿司匹林患者的早期死亡率。在既往未使用阿司匹林的患者中，20.1%的患者在卒中的前3周内死亡，而既往使用阿司匹林的患者中仅11.5%在同一时期死亡。两组的早期死亡率差异极显著（P = 0.0008）。Logistic回归分析显示，阿司匹林的使用是脑卒中早期死亡的独立预测因子（P < 0.01）。结论：每日小剂量（100-300 mg）阿司匹林对降低脑卒中早期死亡风险具有保护作用。
Background: Millions of people around the world regularly consume aspirin, but its value in determining stroke severity is still not clear. It has been stated that prior aspirin use might reduce the severity of ischemic stroke by reducing the size of fibrin-platelet emboli or by ameliorating platelet hyperaggregability that occurs in the microcirculation. However there are only few large studies focusing on the early outcome of stroke patients including both ischemic stroke and primary intracerebral hemorrhage patients with prior aspirin therapy.Review Summary: We retrospectively analyzed the medical records of 2509 consecutive stroke patients who were hospitalized in the 2nd Neurology Clinic of Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey, during the period of 1993-2003. We compared the early mortality rates in the patients with prior aspirin use versus the patients without. Of the patients without prior aspirin use, 20.1% died during the first 3 weeks of the stroke, while only 11.5% of the patients with prior aspirin use died during the same period. The difference in early mortality rate between 2 groups was extremely significant (P = 0.0008). Logistic regression analysis indicated that aspirin use was a significant (P < 0.01) and independent predictor of early stroke mortality.Conclusion: Daily low dose (100-300 mg) aspirin has a protective effect in reducing the risk of early death in stroke.