Stroke Research and Treatment (Jan 2018)
Longitudinal Study on Low-Dose Aspirin versus Placebo Administration in Silent Brain Infarcts: The Silence Study
- Ilaria Maestrini,
- Marta Altieri,
- Laura Di Clemente,
- Edoardo Vicenzini,
- Patrizia Pantano,
- Eytan Raz,
- Mauro Silvestrini,
- Leandro Provinciali,
- Isabella Paolino,
- Carmine Marini,
- Matteo Di Giuseppe,
- Tommasina Russo,
- Francesco Federico,
- Cristiana Coppola,
- Maria Pia Prontera,
- Domenico Maria Mezzapesa,
- Vincenzo Lucivero,
- Lucilla Parnetti,
- Paola Sarchielli,
- Maria Peducci,
- Domenico Inzitari,
- Giovanna Carlucci,
- Carlo Serrati,
- Carla Zat,
- Anna Cavallini,
- Alessandra Persico,
- Giuseppe Micieli,
- Stefano Bastianello,
- Vittorio Di Piero
Affiliations
- Ilaria Maestrini
- Department of Human Neuroscience, “Sapienza” University of Rome, Rome, Italy
- Marta Altieri
- Department of Human Neuroscience, “Sapienza” University of Rome, Rome, Italy
- Laura Di Clemente
- Department of Human Neuroscience, “Sapienza” University of Rome, Rome, Italy
- Edoardo Vicenzini
- Department of Human Neuroscience, “Sapienza” University of Rome, Rome, Italy
- Patrizia Pantano
- Department of Human Neuroscience, “Sapienza” University of Rome, Rome, Italy
- Eytan Raz
- Department of Human Neuroscience, “Sapienza” University of Rome, Rome, Italy
- Mauro Silvestrini
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
- Leandro Provinciali
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
- Isabella Paolino
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
- Carmine Marini
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy
- Matteo Di Giuseppe
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy
- Tommasina Russo
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy
- Francesco Federico
- Department of Neurology and Psychiatrics, University of Bari, Bari, Italy
- Cristiana Coppola
- Department of Neurology and Psychiatrics, University of Bari, Bari, Italy
- Maria Pia Prontera
- Department of Neurology and Psychiatrics, University of Bari, Bari, Italy
- Domenico Maria Mezzapesa
- Department of Neurology and Psychiatrics, University of Bari, Bari, Italy
- Vincenzo Lucivero
- Department of Neurology and Psychiatrics, University of Bari, Bari, Italy
- Lucilla Parnetti
- Neurologic Clinic, Department of Medical and Surgical Specialties and Public Health, University of Perugia, Perugia, Italy
- Paola Sarchielli
- Neurologic Clinic, Department of Medical and Surgical Specialties and Public Health, University of Perugia, Perugia, Italy
- Maria Peducci
- Neurologic Clinic, Department of Medical and Surgical Specialties and Public Health, University of Perugia, Perugia, Italy
- Domenico Inzitari
- Department of NEUROFARBA, University of Florence, Florence, Italy
- Giovanna Carlucci
- Department of NEUROFARBA, University of Florence, Florence, Italy
- Carlo Serrati
- Department of Neurology, IRCCS San Martino Hospital-IST, Genoa, Italy
- Carla Zat
- Neurological Division, Ospedale Civile di Imperia, Imperia, Italy
- Anna Cavallini
- Department of Cerebrovascular Diseases, Fondazione “Istituto Neurologico C. Mondino”, Pavia, Italy
- Alessandra Persico
- Department of Cerebrovascular Diseases, Fondazione “Istituto Neurologico C. Mondino”, Pavia, Italy
- Giuseppe Micieli
- Department of Cerebrovascular Diseases, Fondazione “Istituto Neurologico C. Mondino”, Pavia, Italy
- Stefano Bastianello
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- Vittorio Di Piero
- Department of Human Neuroscience, “Sapienza” University of Rome, Rome, Italy
- DOI
- https://doi.org/10.1155/2018/7532403
- Journal volume & issue
-
Vol. 2018
Abstract
Background. We investigated low-dose aspirin (ASA) efficacy and safety in subjects with silent brain infarcts (SBIs) in preventing new cerebrovascular (CVD) events as well as cognitive impairment. Methods. We included subjects aged ≥45 years, with at least one SBI and no previous CVD. Subjects were followed up to 4 years assessing CVD and SBI incidence as primary endpoint and as secondary endpoints: (a) cardiovascular and adverse events and (b) cognitive impairment. Results. Thirty-six subjects received ASA while 47 were untreated. Primary endpoint occurred in 9 controls (19.1%) versus 2 (5.6%) in the ASA group (p=0.10). Secondary endpoints did not differ in the two groups. Only baseline leukoaraiosis predicts primary [OR 5.4 (95%CI 1.3-22.9, p=0.022)] and secondary endpoint-a [3.2 (95%CI 1.1-9.6, p=0.040)] occurrence. Conclusions. These data show an increase of new CVD events in the untreated group. Despite the study limitations, SBI seems to be a negative prognostic factor and ASA preventive treatment might improve SBI prognosis. EU Clinical trial is registered with EudraCT Number: 2005-000996-16; Sponsor Protocol Number: 694/30.06.04.
