Use of aspirin in Chinese after recovery from primary intracranial haemorrhage

Boon-Hor Chong; Koon-Ho Chan; Vincent Pong; Kui-Kai Lau; Yap-Hang Chan; Ming-Liang Zuo; Wai-Man Lui; Gilberto Ka-Kit Leung; Chu-Pak Lau; Hung-Fat Tse; Jenny Kan-Suen Pu; Chung-Wah Siu

doi:10.1160/TH11-06-0439

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2012; 107(02): 241-247
DOI: 10.1160/TH11-06-0439

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Use of aspirin in Chinese after recovery from primary intracranial haemorrhage

Authors

Boon-Hor Chong

¹Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Koon-Ho Chan

²Neurology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Vincent Pong

¹Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Kui-Kai Lau

²Neurology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Yap-Hang Chan

⁴Department of Community Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Ming-Liang Zuo

¹Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Wai-Man Lui

³Department of Neurosurgery, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Gilberto Ka-Kit Leung

³Department of Neurosurgery, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Chu-Pak Lau

¹Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Hung-Fat Tse

¹Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Jenny Kan-Suen Pu

³Department of Neurosurgery, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
Chung-Wah Siu

¹Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China

Abstract

Summary

Intracranial haemorrhage (ICH) accounts for ~35% of all strokes in Chinese. Anti-platelet agent is often avoided after an index event due to the possibility of recurrent ICH. This single-centered observational study included 440 consecutive Chinese patients with a first spontaneous ICH surviving the first month performed during 1996–2010. The subjects were identified, and their clinical characteristics, anti-platelet therapy after ICH, and outcomes including recurrent ICH, ischaemic stroke, and acute coronary syndrome were checked from hospital records. Of these 440 patients, 56 patients (12.7%) were prescribed aspirin (312 patient-aspirin years). After a follow-up of 62.2 ± 1.8 months, 47 patients had recurrent ICH (10.7%, 20.6 per 1,000 patient years). Patients prescribed aspirin did not have a higher risk of recurrent ICH compared with those not prescribed aspirin (22.7 per 1,000 patient-aspirin years vs. 22.4 per 1,000 patient years, p=0.70). Multivariate analysis identified age > 60 years (hazard ratio [HR]: 2.0, 95% confidence interval [CI]: 1.07–3.85, p=0.03) and hypertension (HR: 2.0, 95% CI: 1.06–3.75, p=0.03) as independent predictors for recurrent ICH. In a subgroup analysis including 127 patients with standard indications for aspirin of whom 56 were prescribed aspirin, the incidence of combined vascular events including recurrent ICH, ischaemic stroke, and acute coronary syndrome was statistically lower in patients prescribed aspirin than those not prescribed aspirin (52.4 per 1,000 patient-aspirin years, vs. 112.8 per 1,000 patient-years, p=0.04). In conclusion, we observed in a cohort of Chinese post-ICH patients that aspirin use was not associated with an increased risk for a recurrent ICH.

Keywords

Antiplatelet agents - risk factors - stroke / prevention

Full Text

References

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