Key result
Antiplatelet therapy after ICH is linked to ~47% lower hemorrhagic stroke recurrence without ischemic benefit.
Why the study?
Risk factors for recurrence of hemorrhagic or ischemic stroke in patients with ICH remain inconclusive.
Does antiplatelet therapy reduce new-onset hemorrhagic or ischemic stroke in patients with hemorrhagic stroke?
Cohort (n=7,589)
Yes
Does antiplatelet therapy reduce new-onset hemorrhagic or ischemic stroke in patients with hemorrhagic stroke?
In patients with a history of hemorrhagic stroke, antiplatelet therapy may reduce the risk of recurrent hemorrhagic stroke without significantly affecting the risk of ischemic stroke recurrence.
May support antiplatelet resumption after ICH to lower hemorrhagic recurrence risk; hypothesis-generating and requires randomized confirmation.
The risk factors for recurrence of hemorrhagic or ischemic stroke in patients with intracranial hemorrhage (ICH) are inconclusive. This study was designed to investigate the risk factors for stroke recurrence and the impact of antiplatelet on stroke recurrence in patients with ICH. This population-based case-cohort study analyzed the data obtained from a randomized sample of 2 million subjects in the Taiwan National Health Insurance Research Database. The survival of patients with hemorrhagic stroke from January 1, 2000, to December 31, 2013, was included in the study. During the 5-year follow-up period, the recurrence rate of stroke was 13.1% (7.01% hemorrhagic stroke, and 6.12% ischemic stroke). The recurrence rate of stroke was 13.3% in the without antiplatelet group and 12.6% in the antiplatelet group. The risk factor for hemorrhagic stroke was hypertension (OR 1.87). The risk factors for ischemic stroke were age (OR 2.99), diabetes mellitus (OR 1.28), hypertension (OR 2.68), atrial fibrillation (OR 1.97), cardiovascular disease (OR 1.42), and ischemic stroke history (OR 1.68). Antiplatelet may decrease risk of hemorrhagic stroke (OR 0.53). The risk of stroke recurrence is high in patients with ICH. Hypertension is a risk factor for ischemic and hemorrhagic stroke recurrence. Antiplatelet therapy does not decrease risk of ischemic stroke recurrence but may reduce recurrence of hemorrhagic stroke.
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Wong et al. (2022) conducted a cohort in Hemorrhagic stroke (n=7,589). Antiplatelet drugs (aspirin, ticlopidine, clopidogrel) vs. Without antiplatelet drugs was evaluated on Hemorrhagic stroke recurrence (HR 0.53, 95% CI 0.42-0.66, p=<0.01). Antiplatelet therapy significantly decreased the risk of hemorrhagic stroke recurrence (HR 0.53) but did not reduce the risk of ischemic stroke recurrence in patients with intracranial hemorrhage.
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