January 3, 2006

Outcome of bleeding stroke poor with aspirin use

NEW YORK (Reuters Health) - 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.