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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Mechanism of stroke in patients taking aspirin

M I Chimowitz1, A J Furlan, S Nayak

  • 1Department of Neurology, Cleveland Clinic Foundation, OH 44195.

Neurology
|November 1, 1990
PubMed

Insights

This study found that stroke in aspirin users has diverse causes and often leads to severe disability. Patients with carotid disease on aspirin frequently have high-grade stenosis, and strokes of unknown cause may recur.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Aspirin is a common antiplatelet medication used for stroke prevention.
  • Understanding stroke mechanisms in patients on aspirin is crucial for effective treatment and secondary prevention.
  • Cerebral infarction can occur despite antiplatelet therapy, necessitating investigation into underlying causes.

Purpose of the Study:

  • To prospectively investigate the mechanisms and severity of cerebral infarction in patients undergoing aspirin therapy.
  • To identify specific etiological factors contributing to stroke in this patient cohort.
  • To assess the functional outcomes and recurrence patterns of stroke in aspirin-treated individuals.

Main Methods:

  • Prospective study of 47 patients experiencing cerebral infarction while on aspirin therapy over a 1-year period.
  • Classification of stroke mechanisms, including large-artery atherosclerosis, cardioembolism, and small-vessel occlusive disease.
  • Evaluation of carotid artery status, degree of stenosis, and history of previous strokes.

Main Results:

  • Stroke mechanisms were undetermined in 26% of patients.
  • Identified mechanisms included large-artery atherosclerosis (40%), cardioembolism (32%), and small-vessel disease (11%).
  • Among patients with carotid atherosclerosis, 82% had >90% stenosis or occlusion.
  • Moderate to severe disability occurred in 57% of patients post-stroke.
  • Patients with stroke of undetermined mechanism had a high rate (83%) of prior stroke, often also of undetermined cause.

Conclusions:

  • Stroke in aspirin users exhibits diverse etiologies and frequently results in significant disability.
  • High-grade carotid stenosis or occlusion is common in aspirin-treated patients with carotid disease and stroke.
  • Strokes of undetermined mechanism may have a higher recurrence rate in patients taking aspirin.

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