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(Stroke. 2008;39:845.)
© 2008 American Heart Association, Inc.

Original Contributions

Nonaspirin Nonsteroidal Anti-inflammatory Drugs and Hemorrhagic Stroke Risk

The Acute Brain Bleeding Analysis Study

Nam-Kyong Choi, PhD; Byung-Joo Park, MD, PhD; Sang-Wuk Jeong, MD, PhD; Kyung-Ho Yu, MD, PhD Byung-Woo Yoon, MD, PhD

From Department of Preventive Medicine (N.-K.C., B.-J.P.) and Department of Neurology (B.-W.Y.), Seoul National University College of Medicine, Seoul, Korea; Department of Neurology (S.-W.J.), Dongguk University International Hospital, Dongguk University College of Medicine, Goyang, Korea; Department of Neurology (K.-H.Y.), Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

Correspondence to Byung-Woo Yoon, Department of Neurology, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, Korea. E-mail bwyoon{at}snu.ac.kr

Background and Purpose— The relationship between nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) and hemorrhagic stroke (HS) remains unclear. We examined the risk of HS associated with the use of NANSAIDs in Koreans.

Methods— We performed a nationwide, multicenter case-control study from 2002 to 2004. This study included 940 nontraumatic acute HS cases in patients aged 30 to 84 years, with an absence of a history of stroke or hemorrhage-prone brain lesions, alongside 940 community controls, matched to each case by age and sex. Pretrained interviewers obtained information on prescription drugs as well as over-the-counter drugs taken within 14 days before the onset of stroke. We adjusted potential confounders, including family histories of stroke, histories of hypertension, smoking, alcohol consumption, high salt intake, and laborious work hours. The adjusted ORs and their 95% CIs were calculated by conditional logistic regression.

Results— The proportion of NANSAIDs exposure within 14 days was 2.9% for HS patients and 2.0% for the controls. The adjusted odds ratios of stroke in NANSAIDs users compared with nonusers was 1.12 (95% CI, 0.77 to 1.65) for all HS, 1.03 (95% CI, 0.49 to 2.18) for subarachnoid hemorrhage, and 1.19 (95% CI, 0.76 to 1.87) for intracerebral hemorrhage.

Conclusions— No increased risk of HS either subarachnoid hemorrhage or intracerebral hemorrhage was found among NANSAIDs users.

Key Words: anti-inflammatory agents • case-control studies • hemorrhagic • nonsteroidal • stroke