Relation of Pre-Stroke Aspirin Use With Cerebral Infarct Volume and Functional Outcomes
- Authors
- Ryu, Wi-Sun; Schellingerhout, Dawid; Hong, Keun-Sik; Jeong, Sang-Wuk; Kim, Beom Joon; Kim, Joon-Tae; Lee, Kyung Bok; Park, Tai Hwan; Park, Sang-Soon; Park, Jong-Moo; Kang, Kyusik; Cho, Yong-Jin; Park, Hong-Kyun; Lee, Byung-Chul; Yu, Kyung-Ho; Oh, Mi Sun; Lee, Soo Joo; Kim, Jae Guk; Cha, Jae-Kwan; Kim, Dae-Hyun; Lee, Jun; Han, Moon-Ku; Park, Man Seok; Choi, Kang-Ho; Nahrendorf, Matthias; Lee, Juneyoung; Bae, Hee-Joon; Kim, Dong-Eog
- Issue Date
- Nov-2021
- Publisher
- WILEY
- Citation
- ANNALS OF NEUROLOGY, v.90, no.5, pp.763 - 776
- Indexed
- SCIE
SCOPUS
- Journal Title
- ANNALS OF NEUROLOGY
- Volume
- 90
- Number
- 5
- Start Page
- 763
- End Page
- 776
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/135907
- DOI
- 10.1002/ana.26219
- ISSN
- 0364-5134
- Abstract
- Objective: We investigated (1) the associations between pre-stroke aspirin use and thrombus burden, infarct volume, hemorrhagic transformation, early neurological deterioration (END), and functional outcome, and (2) whether stroke subtypes modify these associations in first-ever ischemic stroke. Methods: This multicenter magnetic resonance imaging (MRI)-based study included 5,700 consecutive patients with acute first-ever ischemic stroke, who did not undergo intravenous thrombolysis or endovascular thrombectomy, from May 2011 through February 2014. Propensity score-based augmented inverse probability weighting was performed to estimate adjusted effects of pre-stroke aspirin use. Results: The mean age was 67 years (41% women), and 15.9% (n = 907) were taking aspirin before stroke. Pre-stroke aspirin use (vs nonuse) was significantly related to a reduced infarct volume (by 30%), particularly in large artery atherosclerosis stroke (by 45%). In cardioembolic stroke, pre-stroke aspirin use was associated with a similar to 50% lower incidence of END (adjusted difference = -5.4%, 95% confidence interval [CI] = -8.9 to -1.9). Thus, pre-stroke aspirin use was associated with similar to 30% higher likelihood of favorable outcome (3-month modified Rankin Scale score < 3), particularly in large artery atherosclerosis stroke and cardioembolic stroke (adjusted difference = 7.2%, 95% CI = 1.8 to 12.5 and adjusted difference = 6.4%, 95% CI = 1.7 to 11.1, respectively). Pre-stroke aspirin use (vs nonuse) was associated with 85% less frequent cerebral thrombus-related susceptibility vessel sign (SVS) in large artery atherosclerosis stroke (adjusted difference = -1.4%, 95% CI = -2.1 to -0.8, p < 0.001) and was associated with similar to 40% lower SVS volumes, particularly in cardioembolic stroke (adjusted difference = -0.16 cm(3), 95% CI = -0.29 to -0.02, p = 0.03). Moreover, pre-stroke aspirin use was not significantly associated with hemorrhagic transformation (adjusted difference = -1.1%, p = 0.09). Interpretation :Pre-stroke aspirin use associates with improved functional independence in patients with first-ever ischemic large arterial stroke by reducing infarct volume and/or END, likely by decreasing thrombus burden, without increased risk of hemorrhagic transformation.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholar.korea.ac.kr/handle/2021.sw.korea/135907)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.