Published online Nov 16, 2023. doi: 10.12998/wjcc.v11.i32.7814
Peer-review started: September 25, 2023
First decision: October 17, 2023
Revised: October 18, 2023
Accepted: November 2, 2023
Article in press: November 2, 2023
Published online: November 16, 2023
The optimal timing and dose of aspirin initiation after an acute stroke are still debated. This study aimed to evaluate the efficacy and safety of aspirin antiplatelet therapy within 48 h of symptom onset in patients with acute stroke. A randomized controlled trial was conducted. The primary outcome was the occurrence of recurrent stroke, myocardial infarction, or vascular death within 90 d. Secondary outcomes comprised functional outcomes, bleeding complications, and mortality rates. Results showed favorable functional outcomes with aspirin use, but no significant reduction in recurrent vascular events. Larger studies with longer follow-up periods are needed for further confirmation.
The optimal timing and dose of aspirin initiation after acute stroke are still debated, highlighting the need for further investigation. This study aimed to evaluate the efficacy and safety of aspirin antiplatelet therapy within 48 h of symptom onset in patients with acute stroke. Understanding the impact of aspirin use on functional outcomes and recurrent vascular events is crucial for informing clinical decision-making and optimizing patient care. Larger studies with longer follow-up periods will provide more conclusive evidence in this field and guide future management strategies for acute stroke patients.
The primary aim was to assess the occurrence of recurrent stroke, myocardial infarction, or vascular death within 90 days. Secondary objectives included evaluating functional outcomes at 90 d using the modified Rankin Scale, determining the incidence of bleeding complications, and comparing mortality rates between the aspirin and no aspirin groups. By addressing these objectives, the study aimed to provide valuable insights into the use of aspirin in acute stroke management.
A randomized, open-label, controlled trial was conducted involving 60 patients with acute ischemic or hemorrhagic stroke admitted within 24 h of symptom onset. Patients were randomly assigned to receive either a daily dose of 300 mg aspirin or no aspirin within 48 h of stroke onset. The primary outcome measured was the occurrence of recurrent stroke, myocardial infarction, or vascular death within 90 d. Secondary outcomes included functional outcomes at 90 d using the modified Rankin Scale (mRS), the incidence of bleeding complications, and mortality rate. Baseline characteristics were balanced between the two groups, and statistical analyses were performed to assess the relative risk and significance of the outcomes.
Among the 60 patients included, those in the aspirin group showed favorable functional outcomes compared to the no aspirin group, as indicated by significantly lower modified Rankin Scale (mRS) scores at 90 d. However, there was no significant reduction in the occurrence of recurrent stroke, myocardial infarction, or vascular death between the two groups. The incidence of bleeding complications and mortality rates were comparable between the aspirin and no aspirin groups. Further studies with larger sample sizes and longer follow-up periods are necessary to validate these findings.
Aspirin use within 48 h of symptom onset in acute stroke patients is associated with improved functional outcomes. However, there is no significant reduction in the risk of recurrent stroke, myocardial infarction, or vascular death compared to not using aspirin. The safety profile of aspirin is similar to that of no aspirin in terms of bleeding complications and mortality rates. To validate these results, further research with larger sample sizes and longer follow-up periods is necessary.
The study results highlight the need for further investigation into the optimal timing and dose of aspirin initiation after acute stroke. Future studies should consider larger sample sizes and longer follow-up periods to confirm the findings regarding functional outcomes and the risk reduction of recurrent vascular events. Additionally, exploring alternative antiplatelet therapies or combination treatments may provide valuable insights into improving outcomes in acute stroke management. Overall, ongoing research is necessary to refine the use of aspirin and optimize its benefits in the context of acute stroke.