title: Aspirin as a promising agent for decreasing incidence of cerebral aneurysm rupture.
abstract: OBJECTIVE
  Chronic inflammation is postulated as an important phenomenon in intracranial aneurysm wall pathophysiology. This study was conducted to determine if aspirin use impacts the occurrence of intracranial aneurysm rupture.
  
  
  METHODS
  Subjects enrolled in the International Study of Unruptured Intracranial Aneurysms (ISUIA) were selected from the prospective untreated cohort (n=1691) in a nested case-control study. Cases were subjects who subsequently had a proven aneurysmal subarachnoid hemorrhage during a 5-year follow-up period. Four control subjects were matched to each case by site and size of aneurysm (58 cases, 213 control subjects). Frequency of aspirin use was determined at baseline interview. Aspirin frequency groups were analyzed for risk of aneurysmal hemorrhage. Bivariable and multivariable analyses were performed using conditional logistic regression.
  
  
  RESULTS
  A trend of a protective effect for risk of unruptured intracranial aneurysm rupture was observed. Patients who used aspirin 3× weekly to daily had an OR for hemorrhage of 0.40 (95% CI, 0.18-0.87); reference group, no use of aspirin), patients in the "< once a month" group had an OR of 0.80 (95% CI, 0.31-2.05), and patients in the "> once a month to 2×/week" group had an OR of 0.87 (95% CI, 0.27-2.81; P=0.025). In multivariable risk factor analyses, patients who used aspirin 3 times weekly to daily had a significantly lower odds of hemorrhage (adjusted OR, 0.27; 95% CI, 0.11-0.67; P=0.03) compared with those who never take aspirin.
  
  
  CONCLUSIONS
  Frequent aspirin use may confer a protective effect for risk of intracranial aneurysm rupture. Future investigation in animal models and clinical studies is needed.
authors: Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, USA.
authors: David M
authors: DM
authors: Hasan
authors: Kelly B
authors: KB
authors: Mahaney
authors: Robert D
authors: RD
authors: Brown
authors: Irene
authors: I
authors: Meissner
authors: David G
authors: DG
authors: Piepgras
authors: John
authors: J
authors: Huston
authors: Ana W
authors: AW
authors: Capuano
authors: James C
authors: JC
authors: Torner
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000453:epidemiology* / Q000517:prevention & control*; D001241:Aspirin / Q000008:administration & dosage*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D001241:Aspirin