Antecedent Aspirin Use Is Associated with Less Severe Symptoms on Admission for Ischemic Stroke.
BACKGROUND
Aspirin is known to reduce stroke risk; however, its role in reducing severity of ischemic syndrome is not clear. We sought to investigate the relationship between antecedent aspirin use and stroke severity in patients presenting with acute ischemic stroke (AIS).


METHODS
We retrospectively analyzed a prospectively collected database of consecutive AIS patients presenting to our center. Clinical characteristics (including antecedent aspirin use), imaging findings, and laboratory data were assessed in association with presenting stroke severity, as measured by the National Institutes of Health Stroke Scale (NIHSS). Logistic regression models were used to determine univariate and multivariate predictors of baseline NIHSS.


RESULTS
Of the 610 AIS patients with admission brain magnetic resonance imaging available for volumetric analysis of acute infarct size, 241 (39.5%) used aspirin prior to stroke onset. Antecedent aspirin use (P = .0005), history of atrial fibrillation (P < .0001), acute infarct volume (P < .0001), initial systolic blood pressure (P = .041), admission glucose level (P = .0027), and stroke subtype (P < .0001) were associated with presenting stroke severity in univariate analysis. Antecedent aspirin use (P < .0001), history of atrial fibrillation (P < .0002), acute infarct volume (P < .0001), systolic blood pressure (P = .038), and glucose level (P = .0095) remained independent predictors of NIHSS in multivariable analysis.


CONCLUSIONS
Antecedent aspirin use was independently associated with milder presenting stroke severity, even after accounting for acute infarct volume. While the underlying biology of this apparent protective relationship requires further study, patients at high risk of stroke may benefit from routine aspirin use.
['Nelson|Sarah|S|', 'Cloonan|Lisa|L|', 'Kanakis|Allison S|AS|', 'Fitzpatrick|Kaitlin M|KM|', 'Shideler|Kelsey I|KI|', 'Perilla|Adriana S|AS|', 'Furie|Karen L|KL|', 'Rost|Natalia S|NS|']
D000368:Aged D000369:Aged, 80 and over D001241:Aspirin D001281:Atrial Fibrillation D015415:Biomarkers D001786:Blood Glucose D001794:Blood Pressure D002545:Brain Ischemia D002317:Cardiovascular Agents D016009:Chi-Square Distribution D016208:Databases, Factual D038524:Diffusion Magnetic Resonance Imaging D004185:Disability Evaluation D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D016017:Odds Ratio D010343:Patient Admission D011237:Predictive Value of Tests D065840:Protective Factors D012189:Retrospective Studies D012307:Risk Factors D012720:Severity of Illness Index D020521:Stroke
aspirin atrial fibrillation blood pressure glucose Brain infarction