Aspirin withdrawal: A risk factor for ischemic stroke severity

Area of Science:

• Neurology
• Cardiovascular Medicine
• Clinical Research

Background:

• Aspirin cessation is linked to recurrent ischemic stroke (IS) due to a potential rebound phenomenon.
• The impact of aspirin withdrawal on IS severity (ISS) remains largely unexplored.

Purpose of the Study:

• To investigate whether aspirin withdrawal is a significant risk factor for increased IS severity.

Main Methods:

• A case-control study involving 50 patients who experienced IS within 2 weeks of aspirin withdrawal and 50 matched controls.
• Ischemic stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) on admission and the modified Rankin scale (mRS) at 3-month follow-up.

Main Results:

• Patients who withdrew from aspirin (cases) exhibited more severe strokes upon admission compared to controls (mean NIHSS: 12.76 vs 10.04).
• Multivariate analysis identified aspirin discontinuation as a direct risk factor for ISS, independent of other cardiovascular risk factors.

Conclusions:

• Aspirin interruption, even for a short period (e.g., 15 days), may lead to more severe acute ischemic strokes.
• Further large-scale studies are warranted to explore various withdrawal durations and confirm these findings.