Aspirin withdrawal: A risk factor for ischemic stroke severity.

J Med Vasc

Department of Neurology, Ibn Rochd Hospital, Hassan II University, Faculty of Medicine and Pharmacy, rue Tarik Ibn Ziad, 20360 Casablanca, Morocco; Research Laboratory on diseases of the nervous system, neurosensory and disability, Hassan II University, Faculty of Medicine and Pharmacy, rue Tarik Ibn Ziad, 20360 Casablanca, Morocco.

Published: July 2021

Introduction: Acetylsalicylic acid (ASA) cessation, is suggestive of a rebound phenomenon laying the ground for ischemic stroke (IS) re-occurrence but nothing is known about its implication for IS severity (ISS). Thus, the aim of our study is to examine whether or not aspirin withdrawal is a risk factor for ISS.

Patients And Methods: This study, recruited patients having presented an IS in the following 2 weeks of ASA withdrawal, matched with treatment free cases. ISS was evaluated in all patients at admission using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin scale (mRS) at 3 months' follow-up.

Findings: Fifty cases were included in this study and fifty, manually matched, controls. ISS analysis found that the case group had a more severe stroke at admission (mean NIHSS: 12.76 (±7.319) in cases vs 10.04 (±5.562) in controls, P=0.039), with ASA discontinuation judged as a risk factor directly related to ISS regardless of the underlying cardiovascular risk factors (using the multivariate analysis).

Conclusion: Our study's findings suggest that aspirin interruption over a 15-days period could result in a more severe IS in the acute phase. To our knowledge, no study has ever discussed this outcome, shedding the light on the pressing need for larger studies with various withdrawal periods to support these data.

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http://dx.doi.org/10.1016/j.jdmv.2021.05.004DOI Listing

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