Role of aspirin discontinuation in recurrence of ischemic cerebrovascular stroke

Abstract

Abstract Background Discontinuation of aspirin was suggested to be a risk factor for recurrent ischemic stroke; however, it was underestimated by most physicians. Objectives Study the effect of aspirin discontinuation in recurrence of ischemic cerebrovascular stroke. Patients and methods This is a descriptive case–control study, including 104 patients with recurrent ischemic stroke and 104 controls. Both sexes were included with age over 18 years. The following information was collected: history of aspirin discontinuation and cause and time of discontinuation. Investigations included brain CT or brain MRI for all patients, and the site of infarction was classified according to the Oxford classification. Results We found that 51% of patients discontinue aspirin compared to 28.8% of the control group. Nearly half of the patients (25/53) discontinue aspirin for 8–30 days before a stroke. Very high-risk patients were associated with stroke in 8–30 days of discontinuation, high-risk patients were associated with stroke in 181–365 days of discontinuation while moderate-risk patients were associated with stroke in 31–180 days of discontinuation. Conclusion Discontinuation of aspirin especially for a period of 8–30 days could increase the risk of recurrent ischemic stroke in patients with very high-risk and high-risk factors. Physicians need to educate patients about the importance of adherence of aspirin therapy.

Keywords

• Aspirin
• Discontinuation
• Recurrent stroke
• Ischemic stroke