Outcome of bleeding stroke poor with aspirin use

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In a Finnish study of 208 patients who suffered a stroke caused by a ruptured blood vessel and bleeding in the brain, regular use of moderate doses of aspirin preceding the stroke predicted a high risk of death in the first 3 months.

“We believe that the untoward effect of aspirin use on short-term outcome was attributable to early enlargement of (brain bleeds) in aspirin-users,” Dr. Pertti Saloheimo from Oulu University Hospital and colleagues write in the American Heart Association’s journal Stroke.

In the study, 33 percent of the 208 patients with intracerebral hemorrhage or ICH, as a bleeding stroke is known technically, died within 3 months of the event.

According to the researchers, patients who reported regular use of aspirin before the stroke occurred had a 2.5-times greater risk of dying in the first 3 months following ICH compared with non-users of aspirin.

“This study,” writes Dr. Stanley Tuhrim, of the Mount Sinai School of Medicine in New York, in a related editorial, “provides added evidence that aspirin use before ICH is a risk factor for continued bleeding and poorer outcome.”

In his editorial, Tuhrim notes that a study published recently in The New England Journal of Medicine showed that treatment with clotting factor VII shortly after the onset of acute ICH limits bleeding, reduces mortality, and improves functional outcomes.

This “somewhat unanticipated” finding, writes Tuhrim, “suggests that improving coagulation processes may be an important avenue of ICH treatment.”

SOURCE: Stroke, January 2006.

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