González-Pérez A, et al. - Patients with a history of haemorrhagic stroke (HS) were investigated to assess how antiplatelet drug use affected mortality. Results here suggested an improved survival in association with low-dose aspirin.

Methods

• Researchers followed 1,004 patients with intracerebral haemorrhage (ICH) and 929 patients with subarachnoid haemorrhage (SAH), starting 30 days after an HS episode, for amedian of 6.4 years.
• The effect of time-dependent exposure to antiplatelets after HS on all-cause mortality was estimated.
• They used Cox proportional hazard models to measure adjusted hazard ratios (aHRs) and 95% confidence intervals (CI).

Results

• With a similar association among ICH (aHR ¼ 0.66; 95% CI: 0.49–0.89) and SAH (aHR ¼ 0.61; 95% CI: 0.36–1.04) patients, current use of low-dose aspirin was found to be associated with a 32% improved survival (aHR ¼ 0.68; 95% CI: 0.53–0.88).
• Individuals who used antithrombotic drugs in the year before the HS showed a statistically significant improved survival associated with current use of low-dose aspirin during follow-up (prior use: aHR ¼ 0.56; 95% CI: 0.39–0.80; non-prior use: aHR ¼ 0.87; 95% CI: 0.61–1.24).
• No association of current use of clopidogrel with survival was observed (aHR ¼ 1.35; 95% CI: 0.88–2.08).
• Improved survival was evident in association with statin use (aHR ¼ 0.38; 95% CI: 0.31–0.47).
• On the other hand, decreased survival was observed in association with discontinuation of statins (aHR ¼ 1.31; 95% CI: 1.02–1.68) or low-dose aspirin (aHR ¼ 1.54; 95% CI: 1.21–1.97).
• To reduce vascular risks, use of low-dose aspirin after an episode of HS was safe; this was particularly observed in patients who were on antithrombotic therapy before the episode.