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Effect of discontinuing aspirin therapy on the risk of brain ischemic stroke

Alexandre Balzano Maulaz1, Daniel C Bezerra, Patrik Michel

  • 1Department of Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

Archives of Neurology
|August 10, 2005
PubMed

Insights

Discontinuing aspirin therapy, even for a short period, significantly increases the risk of ischemic stroke (IS). Maintaining aspirin compliance is crucial, especially for individuals with coronary heart disease.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Clinical Pharmacology

Background:

  • Aspirin (acetylsalicylic acid) is a common preventative treatment for ischemic vascular disease.
  • Emerging data suggest a potential rebound effect following aspirin therapy interruption.
  • The risk associated with discontinuing aspirin therapy requires further investigation.

Purpose of the Study:

  • To investigate aspirin therapy discontinuation as a potential risk factor for ischemic stroke (IS).

Main Methods:

  • A case-control study was conducted within a stroke unit.
  • Participants included 309 patients with IS or transient ischemic attack (TIA) on long-term aspirin and 309 matched controls.
  • Aspirin discontinuation in the 4 weeks preceding the event/interview was compared between groups.

Main Results:

  • Aspirin discontinuation occurred in 13 patients versus 4 controls.
  • Aspirin interruption was associated with an elevated odds ratio of 3.4 for IS/TIA (95% CI, 1.08-10.63; P < .005) after multivariable adjustment.
  • Coronary heart disease was more prevalent in patients with IS/TIA.

Conclusions:

  • Aspirin therapy compliance is critical for preventing ischemic events.
  • Discontinuation of aspirin therapy poses a significant risk for patients susceptible to IS, particularly those with co-existing coronary heart disease.
Abstract

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