Safety of Aspirin Use in Patients With Stroke and Small Unruptured Aneurysms.

Aged Aneurysm, Ruptured / epidemiology Aspirin / adverse effects Cohort Studies Female Humans Intracranial Aneurysm / complications Male Middle Aged Platelet Aggregation Inhibitors / adverse effects Prospective Studies Stroke / complications

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
05 01 2021
Historique:
received: 21 02 2020
accepted: 12 08 2020
pubmed: 16 10 2020
medline: 16 1 2021
entrez: 15 10 2020
Statut: ppublish

Résumé

We initiated a multicenter, prospective cohort study to test the hypothesis that aspirin is safe for patients with ischemic cerebrovascular disease (ICVD) harboring unruptured intracranial aneurysms (UIAs) <7 mm. This prospective, multicenter cohort study consecutively enrolled 1,866 eligible patients with ICVD harboring UIAs <7 mm in diameter from 4 hospitals between January 2016 and August 2019. Baseline and follow-up patient information, including the use of aspirin, was recorded. The primary endpoint was aneurysm rupture. After a total of 4,411.4 person-years, 643 (37.2%) patients continuously received aspirin treatment. Of all included patients, rupture occurred in 12 (0.7%). The incidence rate for rupture (IRR) was 0.27 (95% confidence interval [CI] 0.15-0.48) per 100 person-years. The IRRs were 0.39 (95% CI 0.21-0.72) and 0.06 (95% CI 0.010-0.45) per 100 person-years for the nonaspirin and aspirin groups, respectively. In the multivariate analysis, uncontrolled hypertension and UIAs 5 to <7 mm were associated with a high rate of aneurysm rupture, whereas aspirin use was associated with a low rate of aneurysm rupture. Compared with other groups, the high-risk group (UIAs 5 to <7 mm with concurrent uncontrolled hypertension) without aspirin had higher IRRs. Aspirin is a safe treatment for patients with concurrent small UIAs and ICVD. Patients who are not taking aspirin in the high-risk group warrant intensive surveillance. NCT02846259. This study provides Class III evidence that for patients harboring UIAs <7 mm with ICVD, aspirin does not increase the risk of aneurysm rupture.

Identifiants

DOI: 10.1212/WNL.0000000000010997 PMID: 33055274
pubmed: 33055274
pii: WNL.0000000000010997
doi: 10.1212/WNL.0000000000010997
doi:

Substances chimiques

Platelet Aggregation Inhibitors 0
Aspirin R16CO5Y76E

Banques de données

ClinicalTrials.gov
['NCT02846259']

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e19-e29

Investigateurs

Zang Liu (Z)
Hong- Rui Ma (HR)
Chao Liang (C)

Informations de copyright

© 2020 American Academy of Neurology.

Auteurs

Jian-Cong Weng (JC)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Jie Wang (J)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Xin Du (X)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Hao Li (H)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Yu-Ming Jiao (YM)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Wei-Lun Fu (WL)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Ran Huo (R)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Zi-Han Yan (ZH)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Hong-Yuan Xu (HY)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Shuo Wang (S)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Yong Cao (Y)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China. caoyong@bjtth.org.

Ji-Zong Zhao (JZ)

From the Department of Neurosurgery (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (J.-C.W., J.W., H.L., Y.-M.J., W.-L.F., R.H., Z.-H.Y., H.-Y.X., S.W., Y.C., J.-Z.Z.); Department of Cardiology (X.D.), Beijing Anzhen Hospital, Capital Medical University; and Department of Cardiology (X.D.), Health Research Center, Beijing, People's Republic of China.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Safety of Aspirin Use in Patients With Stroke...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Anévrysme › Rupture d'anévrysme › Safety of Aspirin Use in Patients With Stroke...
questionsmedicales.fr › Composés chimiques organiques › Hydrocarbures › Hydrocarbures cycliques › Hydrocarbures aromatiques › Dérivés du benzène › Phénols › Hydroxybenzoates › Salicylates › Acide acétylsalicylique › Safety of Aspirin Use in Patients With Stroke...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Safety of Aspirin Use in Patients With Stroke...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Safety of Aspirin Use in Patients With Stroke...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Artériopathies intracrâniennes › Anévrysme intracrânien › Safety of Aspirin Use in Patients With Stroke...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Safety of Aspirin Use in Patients With Stroke...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Antiagrégants plaquettaires › Safety of Aspirin Use in Patients With Stroke...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Safety of Aspirin Use in Patients With Stroke...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Safety of Aspirin Use in Patients With Stroke...