Risk of hemorrhagic stroke with aspirin use : An update
Low-dose aspirin is an important therapeutic option in the secondary prevention of myocardial infarction (MI) and ischemic stroke, especially in light of its unique cost-effectiveness and widespread availability. In addition, based on the results of a number of large studies, aspirin is also widely...
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| Veröffentlicht in: | Stroke (1970) 2005-08, Vol.36 (8), p.1801-1807 |
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| creator | GORELICK, Philip B WEISMAN, Steven M |
| description | Low-dose aspirin is an important therapeutic option in the secondary prevention of myocardial infarction (MI) and ischemic stroke, especially in light of its unique cost-effectiveness and widespread availability. In addition, based on the results of a number of large studies, aspirin is also widely used in the primary prevention of MI. This review provides an update of the available data to offer greater clarity regarding the risks of aspirin with respect to hemorrhagic stroke, as well as insights regarding patient selection to minimize the risk of this complication.
In the secondary prevention of cardiovascular, cerebrovascular, and ischemic events, the evidence supports that the benefits of aspirin treatment significantly outweigh the risk of a major hemorrhage. The evidence from primary prevention of MI studies, including that from the recent Women's Health Study evaluation of aspirin use in healthy women, demonstrate that the increased risk for hemorrhagic stroke is small, is comparable to the secondary prevention studies, and fails to achieve statistical significance. A reasonable estimate of the risk of hemorrhagic stroke associated with the use of aspirin in primary prevention patients is 0.2 events per 1000 patient-years, which is comparable to estimates of the risk associated with the use of aspirin in secondary prevention patients.
When considering whether aspirin is appropriate, the absolute therapeutic cardiovascular benefits of aspirin must be balanced with the possible risks associated with its use, with the most serious being hemorrhagic stroke. |
| doi_str_mv | 10.1161/01.STR.0000174189.81153.85 |
| format | Article |
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In the secondary prevention of cardiovascular, cerebrovascular, and ischemic events, the evidence supports that the benefits of aspirin treatment significantly outweigh the risk of a major hemorrhage. The evidence from primary prevention of MI studies, including that from the recent Women's Health Study evaluation of aspirin use in healthy women, demonstrate that the increased risk for hemorrhagic stroke is small, is comparable to the secondary prevention studies, and fails to achieve statistical significance. A reasonable estimate of the risk of hemorrhagic stroke associated with the use of aspirin in primary prevention patients is 0.2 events per 1000 patient-years, which is comparable to estimates of the risk associated with the use of aspirin in secondary prevention patients.
When considering whether aspirin is appropriate, the absolute therapeutic cardiovascular benefits of aspirin must be balanced with the possible risks associated with its use, with the most serious being hemorrhagic stroke.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.STR.0000174189.81153.85</identifier><identifier>PMID: 16020759</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject><![CDATA[Adult ; Aged ; Aged, 80 and over ; Angiography ; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use ; Aspirin - metabolism ; Aspirin - therapeutic use ; Biological and medical sciences ; Blood. Blood coagulation. Reticuloendothelial system ; Brain Ischemia - pathology ; Cardiovascular Diseases - drug therapy ; Cardiovascular Diseases - prevention & control ; Carotid Arteries - pathology ; Carotid Artery, External - pathology ; Cerebral Hemorrhage - prevention & control ; Cerebral Revascularization - methods ; Cerebrovascular Disorders - drug therapy ; Cerebrovascular Disorders - prevention & control ; Clinical Trials as Topic ; Coronary Artery Bypass - methods ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Hemorrhage - etiology ; Hemorrhage - pathology ; Hemorrhage - prevention & control ; Humans ; Ischemia - metabolism ; Ischemia - prevention & control ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Pharmacology. Drug treatments ; Risk ; Stroke - etiology ; Stroke - pathology ; Stroke - prevention & control ; Vascular diseases and vascular malformations of the nervous system]]></subject><ispartof>Stroke (1970), 2005-08, Vol.36 (8), p.1801-1807</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c357t-faebe70ebe9eab2897efcc334527765616b2efce681f894bdb8d1aa3b773d08b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17008435$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16020759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GORELICK, Philip B</creatorcontrib><creatorcontrib>WEISMAN, Steven M</creatorcontrib><title>Risk of hemorrhagic stroke with aspirin use : An update</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Low-dose aspirin is an important therapeutic option in the secondary prevention of myocardial infarction (MI) and ischemic stroke, especially in light of its unique cost-effectiveness and widespread availability. In addition, based on the results of a number of large studies, aspirin is also widely used in the primary prevention of MI. This review provides an update of the available data to offer greater clarity regarding the risks of aspirin with respect to hemorrhagic stroke, as well as insights regarding patient selection to minimize the risk of this complication.
In the secondary prevention of cardiovascular, cerebrovascular, and ischemic events, the evidence supports that the benefits of aspirin treatment significantly outweigh the risk of a major hemorrhage. The evidence from primary prevention of MI studies, including that from the recent Women's Health Study evaluation of aspirin use in healthy women, demonstrate that the increased risk for hemorrhagic stroke is small, is comparable to the secondary prevention studies, and fails to achieve statistical significance. A reasonable estimate of the risk of hemorrhagic stroke associated with the use of aspirin in primary prevention patients is 0.2 events per 1000 patient-years, which is comparable to estimates of the risk associated with the use of aspirin in secondary prevention patients.
When considering whether aspirin is appropriate, the absolute therapeutic cardiovascular benefits of aspirin must be balanced with the possible risks associated with its use, with the most serious being hemorrhagic stroke.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiography</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</subject><subject>Aspirin - metabolism</subject><subject>Aspirin - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood. Blood coagulation. Reticuloendothelial system</subject><subject>Brain Ischemia - pathology</subject><subject>Cardiovascular Diseases - drug therapy</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Carotid Arteries - pathology</subject><subject>Carotid Artery, External - pathology</subject><subject>Cerebral Hemorrhage - prevention & control</subject><subject>Cerebral Revascularization - methods</subject><subject>Cerebrovascular Disorders - drug therapy</subject><subject>Cerebrovascular Disorders - prevention & control</subject><subject>Clinical Trials as Topic</subject><subject>Coronary Artery Bypass - methods</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Hemorrhage - etiology</subject><subject>Hemorrhage - pathology</subject><subject>Hemorrhage - prevention & control</subject><subject>Humans</subject><subject>Ischemia - metabolism</subject><subject>Ischemia - prevention & control</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Pharmacology. Drug treatments</subject><subject>Risk</subject><subject>Stroke - etiology</subject><subject>Stroke - pathology</subject><subject>Stroke - prevention & control</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkF1LwzAUhoMobk7_ghRB71pzkqZJdifDLxgIc16HNE1d3brWpEX892ZbYZfm4iQcnnPe8CB0AzgByOAeQ_K-XCQ4HOApCJkIAEYTwU7QGBhJ4zQj4hSNMaYyJqmUI3Th_VfgCRXsHI0gwwRzJseILyq_jpoyWtm6cW6lPysT-c41axv9VN0q0r6tXLWNem-jafQQHm2hO3uJzkq98fZquCfo4-lxOXuJ52_Pr7OHeWwo411captbjkORVudESG5LYyhNGeE8YxlkOQkdmwkohUzzIhcFaE1zzmmBRU4n6O6wt3XNd299p-rKG7vZ6K1teq8ygUUaov4FIcQFlAVwegCNa7x3tlStq2rtfhVgtfOrMKjgVx39qr1fJXbD10NKn9e2OI4OQgNwOwDaG70pnd6ayh85jvf_pX_CXYMf</recordid><startdate>20050801</startdate><enddate>20050801</enddate><creator>GORELICK, Philip B</creator><creator>WEISMAN, Steven M</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20050801</creationdate><title>Risk of hemorrhagic stroke with aspirin use : An update</title><author>GORELICK, Philip B ; WEISMAN, Steven M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-faebe70ebe9eab2897efcc334527765616b2efce681f894bdb8d1aa3b773d08b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiography</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</topic><topic>Aspirin - metabolism</topic><topic>Aspirin - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood. Blood coagulation. Reticuloendothelial system</topic><topic>Brain Ischemia - pathology</topic><topic>Cardiovascular Diseases - drug therapy</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Carotid Arteries - pathology</topic><topic>Carotid Artery, External - pathology</topic><topic>Cerebral Hemorrhage - prevention & control</topic><topic>Cerebral Revascularization - methods</topic><topic>Cerebrovascular Disorders - drug therapy</topic><topic>Cerebrovascular Disorders - prevention & control</topic><topic>Clinical Trials as Topic</topic><topic>Coronary Artery Bypass - methods</topic><topic>Female</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Hemorrhage - etiology</topic><topic>Hemorrhage - pathology</topic><topic>Hemorrhage - prevention & control</topic><topic>Humans</topic><topic>Ischemia - metabolism</topic><topic>Ischemia - prevention & control</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Pharmacology. Drug treatments</topic><topic>Risk</topic><topic>Stroke - etiology</topic><topic>Stroke - pathology</topic><topic>Stroke - prevention & control</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GORELICK, Philip B</creatorcontrib><creatorcontrib>WEISMAN, Steven M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GORELICK, Philip B</au><au>WEISMAN, Steven M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of hemorrhagic stroke with aspirin use : An update</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2005-08-01</date><risdate>2005</risdate><volume>36</volume><issue>8</issue><spage>1801</spage><epage>1807</epage><pages>1801-1807</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Low-dose aspirin is an important therapeutic option in the secondary prevention of myocardial infarction (MI) and ischemic stroke, especially in light of its unique cost-effectiveness and widespread availability. In addition, based on the results of a number of large studies, aspirin is also widely used in the primary prevention of MI. This review provides an update of the available data to offer greater clarity regarding the risks of aspirin with respect to hemorrhagic stroke, as well as insights regarding patient selection to minimize the risk of this complication.
In the secondary prevention of cardiovascular, cerebrovascular, and ischemic events, the evidence supports that the benefits of aspirin treatment significantly outweigh the risk of a major hemorrhage. The evidence from primary prevention of MI studies, including that from the recent Women's Health Study evaluation of aspirin use in healthy women, demonstrate that the increased risk for hemorrhagic stroke is small, is comparable to the secondary prevention studies, and fails to achieve statistical significance. A reasonable estimate of the risk of hemorrhagic stroke associated with the use of aspirin in primary prevention patients is 0.2 events per 1000 patient-years, which is comparable to estimates of the risk associated with the use of aspirin in secondary prevention patients.
When considering whether aspirin is appropriate, the absolute therapeutic cardiovascular benefits of aspirin must be balanced with the possible risks associated with its use, with the most serious being hemorrhagic stroke.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>16020759</pmid><doi>10.1161/01.STR.0000174189.81153.85</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Angiography Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Aspirin - metabolism Aspirin - therapeutic use Biological and medical sciences Blood. Blood coagulation. Reticuloendothelial system Brain Ischemia - pathology Cardiovascular Diseases - drug therapy Cardiovascular Diseases - prevention & control Carotid Arteries - pathology Carotid Artery, External - pathology Cerebral Hemorrhage - prevention & control Cerebral Revascularization - methods Cerebrovascular Disorders - drug therapy Cerebrovascular Disorders - prevention & control Clinical Trials as Topic Coronary Artery Bypass - methods Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Hemorrhage - etiology Hemorrhage - pathology Hemorrhage - prevention & control Humans Ischemia - metabolism Ischemia - prevention & control Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Pharmacology. Drug treatments Risk Stroke - etiology Stroke - pathology Stroke - prevention & control Vascular diseases and vascular malformations of the nervous system |
| title | Risk of hemorrhagic stroke with aspirin use : An update |
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