Analysis of the efficacy and safety of long-term aspirin in the prevention of ischemic stroke

ObjectiveTo investigate the efficacy and safety of long-term aspirin in the treatment of ischemic stroke.

MethodsA total of 2 381 elderly people in the Physical Examination Center of Chongqing Army Characteristic Medical Center from January 2015 to May 2016 were included.A total of 2 118 people were included in the baseline analysis at the end of 5-year follow-up.The mean age was 71.7 years, and 51.1% were male.The patients were divided into two groups according to the use of aspirin, in which the aspirin group was defined as those who took aspirin when they were recorded according to the prescription, and the non-aspirin group was defined as those who did not take aspirin during the observation period.The primary results observed in the study were ischemic stroke, including ischemic cerebral infarction and transient cerebral ischemia(TIA), and the secondary results were angina pectoris, myocardial infarction, cardiovascular death and all-cause death.Safety results included gastrointestinal hemorrhage, intracranial hemorrhage and other bleeding.Cox proportional hazard model was used to estimate the relationship between aspirin and ischemic stroke.

ResultsThere were 1 015 patients in aspirin group and 1 103 patients in non-aspirin group.At the end of 5-year follow-up, ischemic stroke occurred in 381 patients in the aspirin group and 491 in the non-aspirin group.The primary and secondary results(angina pectoris, myocardial infarction) were significantly different between the two groups(P < 0.05), but there was no significant difference between cardiovascular death and all-cause death(P>0.05).Gastrointestinal bleeding(4.2% vs 2.4%) and gastrointestinal adverse reactions(16.1% vs 8.3%) in the aspirin group were higher than those in the non-aspirin group(P < 0.05).The risk of ischemic stroke was significantly reduced after taking aspirin for < 13 months, 13-24 months, 25-36 months and 37-48 months(P < 0.05), but there was no significant difference in the incidence of ischemic stroke after taking aspirin for 49-60 months(P>0.05).

ConclusionsLong-term use of aspirin gradually reduces the effectiveness of preventing ischemic stroke and increases the risk of gastrointestinal bleeding.