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Association between aspirin-induced hemoglobin decline and outcome after acute ischemic stroke in G6PD-deficient

Yicong Chen1, Jianle Li1, Zilin Ou1

  • 1Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.

CNS Neuroscience & Therapeutics
|August 9, 2021
PubMed

Insights

Glucose-6-phosphate dehydrogenase (G6PD) deficiency increases hemoglobin decline risk during aspirin treatment for ischemic stroke. This decline is linked to poorer stroke outcomes, necessitating careful monitoring in G6PD-deficient patients.

Area of Science:

  • Neurology
  • Hematology
  • Pharmacology

Background:

  • Low-dose aspirin is commonly used for secondary stroke prevention.
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic disorder affecting red blood cells.
  • The impact of G6PD deficiency on aspirin's effects and stroke outcomes is not well understood.

Purpose of the Study:

  • To investigate the effect of G6PD deficiency on hemoglobin levels during aspirin therapy.
  • To assess the association between G6PD deficiency, hemoglobin decline, and outcomes in acute ischemic stroke patients.

Main Methods:

  • A cohort study of 279 acute ischemic stroke patients treated with aspirin 100 mg/day.
  • Comparison of hemoglobin decline (≥25 g/L or 25%) and anemia rates between G6PD-deficient and G6PD-normal groups.
  • Modified Rankin Scale (mRS) at 3 months used to define poor functional outcomes.

Main Results:

  • G6PD-deficient patients showed significantly higher rates of hemoglobin decline (15.0% vs. 3.3%) and anemia (30.0% vs. 14.6%) after aspirin treatment.
  • Higher bilirubin increase observed in the G6PD-deficient group, suggesting hemolysis.
  • G6PD-deficient patients had a higher rate of poor functional outcomes (RR = 1.31) at 3 months.

Conclusions:

  • Aspirin treatment in G6PD-deficient patients with ischemic stroke can lead to significant hemoglobin decrease and hemolysis.
  • Lower hemoglobin levels post-aspirin are associated with increased risk of poor functional outcomes.
  • Close monitoring of hemoglobin is crucial for G6PD-deficient patients with ischemic stroke receiving aspirin.
Abstract

Keywords:
G6PD deficiencyaspirinhemoglobinoutcomestroke

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