Taking an aspirin immediately after suffering a minor stroke could be key to reducing the risk of having a major stroke in the ensuing days, according to researchers.
Although aspirin is already given to people who have had a stroke or transient ischaemic attack (TIA) after they have been assessed in hospital, researchers believe that immediate treatment of aspirin could be beneficial.
Professor Peter Rothwell, from the University of Oxford, UK, who led the latest research, said the risk of a major stroke following a minor event is about 1,000 times higher for a few days.
A previous study – called the EXPRESS Study – demonstrated that urgent medical treatment with a cocktail of different drugs could reduce the one-week risk of stroke from about 10% to about 2%. However, it was not known which drug or ingredient was most important in reducing that risk.
“One of the treatments that we used was aspirin, but we know from other trials that the long-term benefit of aspirin in preventing stroke is relatively modest,” he said.
“We suspected that the early benefit might be much greater. If so, taking aspirin as soon as possible after ‘warning symptoms’ event could be very worthwhile.”
The team – from Oxford, University Medical Centre Utrecht in the Netherlands, University Duisburg-Essen in Germany, and Lund University in Sweden – looked again at data from tens of thousands of patients, some of whom took aspirin prevent further stroke by taking aspirin and others who took the drug after an acute stroke.
Taking the drug in the first few weeks was crucial in reducing the risk of another stroke, with aspirin slashing the early risk of a fatal or disabling stroke by about 70-80% over the first few days and weeks. Aspirin also reduced the severity of these early strokes.
Prof Rothwell said: “Our findings confirm the effectiveness of urgent treatment after TIA and minor stroke – and show that aspirin is the most important component. Immediate treatment with aspirin can substantially reduce the risk and severity of early recurrent stroke. This finding has implications for doctors, who should give aspirin immediately if a TIA or minor stroke is suspected, rather than waiting for specialist assessment and investigations.
“Half of recurrent strokes in people who have a TIA happen before they seek medical attention for the TIA. Encouraging people to take aspirin if they think they may have had a TIA or minor stroke – experiencing sudden-onset unfamiliar neurological symptoms – could help to address this situation, particularly if urgent medical help is unavailable.”
Rothwell P, Algra A, Chen Z et al. Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials. The Lancet 19 May 2016; doi:10.1016/S0140-6736(16)30511-6
Leave a Reply