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Aspirin and Subarachnoid Haemorrhage in the UK Biobank

Frederick Ewbank1, Jacqueline Birks2, Benjamin Gaastra3,4

  • 1Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK. f.ewbank@nhs.net.

Translational Stroke Research
|July 9, 2022
PubMed

Insights

Aspirin use was not linked to overall subarachnoid hemorrhage (SAH) risk in the general population. However, aspirin users showed an increased likelihood of fatal SAH, particularly deaths outside of a hospital setting.

Area of Science:

  • Neurology
  • Epidemiology
  • Pharmacology

Background:

  • Previous research on aspirin and subarachnoid hemorrhage (SAH) has produced inconsistent findings.
  • The general population's risk of SAH in relation to aspirin use requires further investigation.

Purpose of the Study:

  • To investigate the association between aspirin use and the incidence of spontaneous subarachnoid hemorrhage (SAH) in a large, general population cohort.
  • To determine if aspirin use influences the risk of fatal SAH.

Main Methods:

  • Utilized the UK Biobank, a prospective population-based cohort study with extensive baseline data and linkage to national health records.
  • Employed Cox proportional hazards modeling to analyze the relationship between aspirin use and SAH events.
  • Included over 500,000 participants with detailed follow-up data.

Main Results:

  • No significant association was found between aspirin use and SAH of all causes, aneurysmal SAH, or non-aneurysmal SAH.
  • Aspirin use was significantly associated with a higher risk of SAH resulting in death (Hazard Ratio, 1.69 [1.14-2.51]).
  • This increased risk of fatal SAH was particularly pronounced for out-of-hospital deaths (Hazard Ratio, 2.10 [1.13-3.91]).

Conclusions:

  • In the general population, aspirin use does not appear to increase the overall risk of subarachnoid hemorrhage.
  • Aspirin users demonstrated a higher likelihood of experiencing a fatal SAH, especially when death occurred outside of a hospital.
  • Findings contrast with some studies suggesting a protective effect in specific patient groups (e.g., those with known unruptured aneurysms).

Keywords:
Antiplatelet therapyAspirinStrokeStroke prevalenceStroke subtypesSubarachnoid haemorrhage

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