Study investigates optimal window for aspirin initiation in acute stroke cases

Aspirin initiation within 48 hours of acute stroke is associated with favorable functional outcomes, but it does not significantly reduce the risk of recurrent vascular events compared to not taking aspirin, according to a study.

The study found a trend towards a lower occurrence of the primary outcome (recurrent stroke, myocardial infarction, or vascular death amongst patients taking aspirin, but the difference did not reach statistical significance.

In the randomized, open-label, controlled trial, 60 patients with acute ischemic or hemorrhagic stroke admitted within 24 hours of symptom onset were randomly assigned to receive either aspirin at a dosage of 300 mg daily or no aspirin within 48 hours of stroke onset.

The primary outcome, which included the occurrence of recurrent stroke, myocardial infarction, or vascular death within 90 days, found a notable trend. In the aspirin group, 6.7% of patients experienced the primary outcome compared to 16.7% in the no aspirin group, although the difference did not reach statistical significance.

At the 90-day mark, the modified Rankin Scale (mRS) scores indicated a significant improvement in functional outcomes for patients in the aspirin group.

The incidence of bleeding complications was comparable between groups, with both the aspirin and no aspirin groups reporting a rate of 6.7%.

Reference
Zhang JQ, Pan ZB. Efficacy and safety of aspirin antiplatelet therapy within 48 h of symptom onset in patients with acute stroke. World J Clin Cases. 2023;11(32):7814-7821. doi: 10.12998/wjcc.v11.i32.7814. PMID: 38073696; PMCID: PMC10698416.