This Article Full Text Full Text (PDF) All Versions of this Article: 37/1/4    most recent 01.STR.0000196944.24973.f7v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tuhrim, S. Search for Related Content PubMed PubMed Citation Articles by Tuhrim, S. Related Collections Related Article

(Stroke. 2006;37:4.)
© 2006 American Heart Association, Inc.

Editorial

Aspirin-Use Before ICH

A Potentially Treatable Iatrogenic Coagulopathy?

Stanley Tuhrim, MD

From the Mount Sinai Stroke Center, Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029.

Correspondence to Stanley Tuhrim, Box 1137, 1 Gustave L. Levy Place, New York, NY, 10029-6500. E-mail stanley.tuhrim@msnyuhealth.org

Key Words: aspirin • intracerebral hemorrhage

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 129–133.

Oral anticoagulant use and, to a lesser extent, antiplatelet therapy increase the risk of intracerebral hemorrhage (ICH).¹ Individuals who experience ICH while taking anticoagulants tend to have larger hemorrhages and poorer outcomes, and may be more likely to experience enlargement of their hematomas after hospital admission.^2,3 In this issue of Stroke, Saloheimo and colleagues report data from a single center that suggest the same may be true of patients taking aspirin at the time of their hemorrhage.⁴ In this population-based study, regular aspirin-use at onset was an independent risk factor for death by 3 months after hemorrhage (RR 2.5; 95% CI, 1.3 to 4.6). However, only three quarters of the 208 patients in the study were scanned initially on the day of ictus, and only half had repeat scans. Warfarin users had a 73% mortality rate, by far the highest. However, the 43% mortality rate among aspirin users was significantly higher than the 22% mortality rate among nonusers of aspirin or warfarin. Because their initial ICH scores and hematoma sizes were comparable, the authors speculate that hematoma growth may have been the cause. Indeed, by one measure, aspirin use was significantly associated with relative hematoma growth among those individuals who were rescanned, although the association between hematoma growth and mortality did not reach statistical significance. The authors acknowledge that regular aspirin-use may have acted as a proxy for several factors, such as age, diabetes and pre-existing vascular disease that, although not independent predictors . . . [Full Text of this Article]

Related Article:

Regular Aspirin-Use Preceding the Onset of Primary Intracerebral Hemorrhage is an Independent Predictor for Death

Pertti Saloheimo, Mikko Ahonen, Seppo Juvela, Juhani Pyhtinen, Eeva-Riitta Savolainen, and Matti Hillbom
Stroke 2006 37: 129-133. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				A.I. Qureshi and M.F.K. Suri Acute Reversal of Clopidogrel-Related Platelet Inhibition Using Methyl Prednisolone in a Patient with Intracranial Hemorrhage AJNR Am. J. Neuroradiol., November 1, 2008; 29(10): e97 - e97. [Full Text] [PDF]