The effect of 100 mg/d aspirin on the secondary prevention of patients with ischemic stroke

Objective To assess the effects of 100 mg/d aspirin on the secondary prevention of ischemic stroke and its risk of hemorrhagic events.Methods A retrospective study was carried out.Total of 581 patients with first ischemic stroke were divided into two groups:aspirin group and control group.The end point was a new ischemic stroke or cerebral hemorrhagic, gastrointestinal bleeding.The recurrence of ischemic stroke and bleeding events were observed and a subgroup analysis for cerebral ischemic recurrence and bleeding events was conducted for patients with first lacunar stroke in two groups.Results 545 cases were included in the present study,260 patients were allocated to aspirin group and 285 patients were allocated to control group.The recurrence rate of ischemic stroke in aspirin group was obviously lower than that in control group(P = 0.002,RR =0.516,95%CI =0.312～0.739);there was no significant difference in incidence of cerebral hemorrhagic between the two groups(P = 0.423,RR = 1.233,95%CI = 0.692～2.197);there was no obvious difference in incidence of gastrointestinal bleeding between the two groups(P =0.227,RR =3.288,95%CI =0.340～31.814).The recurrence rate of ischemic stroke in patients with first lacunar stroke in aspirin group was significantly lower than that of patients with first lacunar stroke in control group(P =0.010,RR=0.616,95%CI =0.289～0.893 );there was no significant difference in incidence of cerebral hemorrhagic between patients with first lacunar stroke in the two groups(P =0.269,RR =0.852,95%CI = 0.657～3.611).Conclusion For patients presenting with the first ischemic stroke(including lacunar infarction),100mg/d aspirin could reduce recurrence rate of ischemic stroke without increasing the rate of cerebral hemorrhage and gastrointestinal bleeding.