title: Antecedent Aspirin Use Is Associated with Less Severe Symptoms on Admission for Ischemic Stroke.
abstract: BACKGROUND
  Aspirin is known to reduce stroke risk; however, its role in reducing severity of ischemic syndrome is not clear. We sought to investigate the relationship between antecedent aspirin use and stroke severity in patients presenting with acute ischemic stroke (AIS).
  
  
  METHODS
  We retrospectively analyzed a prospectively collected database of consecutive AIS patients presenting to our center. Clinical characteristics (including antecedent aspirin use), imaging findings, and laboratory data were assessed in association with presenting stroke severity, as measured by the National Institutes of Health Stroke Scale (NIHSS). Logistic regression models were used to determine univariate and multivariate predictors of baseline NIHSS.
  
  
  RESULTS
  Of the 610 AIS patients with admission brain magnetic resonance imaging available for volumetric analysis of acute infarct size, 241 (39.5%) used aspirin prior to stroke onset. Antecedent aspirin use (P = .0005), history of atrial fibrillation (P < .0001), acute infarct volume (P < .0001), initial systolic blood pressure (P = .041), admission glucose level (P = .0027), and stroke subtype (P < .0001) were associated with presenting stroke severity in univariate analysis. Antecedent aspirin use (P < .0001), history of atrial fibrillation (P < .0002), acute infarct volume (P < .0001), systolic blood pressure (P = .038), and glucose level (P = .0095) remained independent predictors of NIHSS in multivariable analysis.
  
  
  CONCLUSIONS
  Antecedent aspirin use was independently associated with milder presenting stroke severity, even after accounting for acute infarct volume. While the underlying biology of this apparent protective relationship requires further study, patients at high risk of stroke may benefit from routine aspirin use.
authors.affiliation: J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: senelson13@gmail.com.
authors.forename: Sarah
authors.initials: S
authors.lastname: Nelson
authors.affiliation: J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Lisa
authors.initials: L
authors.lastname: Cloonan
authors.affiliation: J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Allison S
authors.initials: AS
authors.lastname: Kanakis
authors.affiliation: J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Kaitlin M
authors.initials: KM
authors.lastname: Fitzpatrick
authors.affiliation: J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Kelsey I
authors.initials: KI
authors.lastname: Shideler
authors.affiliation: J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Adriana S
authors.initials: AS
authors.lastname: Perilla
authors.affiliation: Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Furie
authors.affiliation: J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Natalia S
authors.initials: NS
authors.lastname: Rost
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D016208:Databases, Factual; D038524:Diffusion Magnetic Resonance Imaging; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010343:Patient Admission; D011237:Predictive Value of Tests; D065840:Protective Factors; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002317:Cardiovascular Agents; D001241:Aspirin
keywords: Brain infarction; aspirin; atrial fibrillation; blood pressure; glucose