Key result
Aspirin discontinuation independently increased the risk of recurrent ischemic stroke compared to continued use (OR 2.331), particularly when discontinued for 8 to 30 days.
Why the study?
Aspirin discontinuation was suggested to be a risk factor for recurrent ischemic stroke, but was underestimated by most physicians.
Does aspirin discontinuation increase the risk of recurrent ischemic stroke in adult patients?
Case-Control (n=208)
No
Does aspirin discontinuation increase the risk of recurrent ischemic stroke in adult patients?
Effect estimate: OR 2.331 (95% CI 1.303-4.171)
Absolute Event Rate: 51% vs 28.8%
p-value: p=0.004
Discontinuation of aspirin, particularly for 8-30 days, is associated with an increased risk of recurrent ischemic stroke, emphasizing the critical importance of medication adherence.
Discontinuation of aspirin was suggested to be a risk factor for recurrent ischemic stroke; however, it was underestimated by most physicians. Study the effect of aspirin discontinuation in recurrence of ischemic cerebrovascular stroke. This is a descriptive case–control study, including 104 patients with recurrent ischemic stroke and 104 controls. Both sexes were included with age over 18 years. The following information was collected: history of aspirin discontinuation and cause and time of discontinuation. Investigations included brain CT or brain MRI for all patients, and the site of infarction was classified according to the Oxford classification. We found that 51% of patients discontinue aspirin compared to 28.8% of the control group. Nearly half of the patients (25/53) discontinue aspirin for 8–30 days before a stroke. Very high-risk patients were associated with stroke in 8–30 days of discontinuation, high-risk patients were associated with stroke in 181–365 days of discontinuation while moderate-risk patients were associated with stroke in 31–180 days of discontinuation. Discontinuation of aspirin especially for a period of 8–30 days could increase the risk of recurrent ischemic stroke in patients with very high-risk and high-risk factors. Physicians need to educate patients about the importance of adherence of aspirin therapy.
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Negm et al. (2019) conducted a case-control in Recurrent ischemic stroke (n=208). Aspirin discontinuation vs. Continued aspirin use was evaluated on Recurrent ischemic stroke (OR 2.331, 95% CI 1.303-4.171, p=0.004). Aspirin discontinuation independently increased the risk of recurrent ischemic stroke compared to continued use (OR 2.331), particularly when discontinued for 8 to 30 days.
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