Relation of Pre-stroke Aspirin Use With Cerebral Infarct Volume and Functional Outcomes

This is interesting because aspirin is NOT recommended for primary prevention(those not having CVD). So your doctor has two conflicting points of view. Not being medically trained I would have your doctor verify that your aspirin use won't cause gastrointestinal bleeding and then start taking aspirin. Don't do this until your doctor prescribes it.

 The lines below are what you need to worry about. Well then do the research that precisely identifies which persons will have this problem. Not doing so is just abdicating responsibility. 

Low-Dose Aspirin Prophylaxis in Elderly Ups Risk of Serious GI Bleeds

Without heart disease, daily aspirin may be too risky

Overall increase of about 60%, large study shows.

The latest here:

Relation of Pre-stroke Aspirin Use With Cerebral Infarct Volume and Functional Outcomes

Wi-Sun Ryu MD, PhD, Dawid Schellingerhout MD, Keun-Sik Hong MD, PhD, Sang-Wuk Jeong MD, PhD, Beom Joon Kim MD, PhD, Joon-Tae Kim MD, PhD, Kyung Bok Lee MD, PhD, … See all authors

First published: 18 September 2021

https://doi.org/10.1002/ana.26219

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/ana.26219.

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Abstract

Objective

We investigated a) the associations between pre-stroke aspirin use and thrombus burden, infarct volume, hemorrhagic transformation, early neurological deterioration (END), and functional outcome, and b) whether stroke subtypes modify these associations in first-ever ischemic stroke.

Methods

This multicenter MRI-based study included 5,700 consecutive patients with acute first-ever ischemic stroke, who did not undergo intravenous thrombolysis or endovascular thrombectomy, from May-2011 through February-2014. Propensity score-based augmented inverse probability weighting was performed to estimate adjusted effects of pre-stroke aspirin use.

Results

The mean age was 67 years (41% women), and 15.9% (n = 907) were taking aspirin before stroke. Pre-stroke aspirin use (vs non-use) was significantly related to a reduced infarct volume (by 30%), particularly in large artery atherosclerosis stroke (by 45%). In cardioembolic stroke, pre-stroke aspirin use was associated with a ~ 50% lower incidence of END (adjusted difference [95% CI], −5.4% [−8.9 to −1.9]). Thus, pre-stroke aspirin use was associated with ~30% higher likelihood of favorable outcome (3-month modified Rankin Scale score < 3), particularly in large artery atherosclerosis stroke and cardioembolic stroke (adjusted difference [95% CI], 7.2% [1.8 to 12.5] and 6.4% [1.7 to 11.1], respectively). Pre-stroke aspirin use (vs non-use) was associated with 85% less frequent cerebral thrombus-related susceptibility vessel sign (SVS) in large artery atherosclerosis stroke (adjusted difference [95% CI], −1.4% [−2.1 to −0.8], p < 0.001) and was associated with ~40% lower SVS-volumes, particularly in cardioembolic stroke (adjusted difference [95% CI], −0.16 cm³ [−0.29 to −0.02], p = 0.03). Moreover, pre-stroke aspirin use was not significantly associated with hemorrhagic transformation (adjusted difference, −1.1%; p = 0.09).

Interpretation

Pre-stroke aspirin use associates with improved functional independence in patients with first-ever ischemic large arterial stroke by reducing infarct volume and/or END, likely by decreasing thrombus burden, without increased risk of hemorrhagic transformation.

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