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November 1997

Does Daily Aspirin Diminish Severity of First-Ever Stroke?

Author Affiliations

From the Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel.

Arch Neurol. 1997;54(11):1369-1371. doi:10.1001/archneur.1997.00550230042014

Background:  There are still uncertainties about aspirin efficacy in first-ever ischemic stroke prevention. Also it is unknown whether the severity of first ischemic stroke can be modified by aspirin pretreatment.

Objective:  To analyze a series of patients who had their first ischemic stroke while taking aspirin to evaluate the ability of aspirin prophylaxis to diminish the severity of first-ever ischemic stroke.

Design:  Case-control study.

Setting:  Tertiary medical center to which patients were referred.

Patients:  All consecutive patients admitted to the Tel Aviv Medical Center, Tel Aviv, Israel, from May 1988 through May 1994 because of first-ever ischemic stroke were divided into 2 groups according to aspirin use before stroke: aspirin-treated and non—aspirin-treated groups.

Main Outcome Measures:  Stroke severity was defined according to activities of daily living within 24 hours after admission: (1) mild stroke, with independence in activities of daily living; (2) moderate stroke, with partial dependency; and (3) severe stroke, with complete dependency. Using X2 test, stroke severity was compared between patients taking aspirin before their stroke and non—aspirin-treated patients.

Results:  Among 2113 consecutive patients with first-ever ischemic stroke, 125 patients had already been taking 100 to 500 mg of aspirin daily. Aspirin-treated and non—aspirin-treated patients did not differ in stroke severity. Mortality was lower in aspirin-treated patients (7.9%) than in non—aspirin-treated patients (12%), but this difference was not statistically significant (P=.17).

Conclusions:  We conclude that aspirin as primary prevention treatment has no significant protective effect on severity of first-ever ischemic stroke. The diminution of mortality after first ischemic stroke in patients who had used aspirin should be investigated further.