title: Use of aspirin in Chinese after recovery from primary intracranial haemorrhage.
abstract: 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.
authors.affiliation: Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China.
authors.forename: Boon-Hor
authors.initials: BH
authors.lastname: Chong
authors.forename: Koon-Ho
authors.initials: KH
authors.lastname: Chan
authors.forename: Vincent
authors.initials: V
authors.lastname: Pong
authors.forename: Kui-Kai
authors.initials: KK
authors.lastname: Lau
authors.forename: Yap-Hang
authors.initials: YH
authors.lastname: Chan
authors.forename: Ming-Liang
authors.initials: ML
authors.lastname: Zuo
authors.forename: Wai-Man
authors.initials: WM
authors.lastname: Lui
authors.forename: Gilberto Ka-Kit
authors.initials: GK
authors.lastname: Leung
authors.forename: Chu-Pak
authors.initials: CP
authors.lastname: Lau
authors.forename: Hung-Fat
authors.initials: HF
authors.lastname: Tse
authors.forename: Jenny Kan-Suen
authors.initials: JK
authors.lastname: Pu
authors.forename: Chung-Wah
authors.initials: CW
authors.lastname: Siu
mesh_terms: D000367:Age Factors; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020300:Intracranial Hemorrhages / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin