HealthDay News — For patients with atherothrombotic stroke, pre-stroke aspirin use may reduce initial stroke severity, according to a study published online January 11 in the Annals of Neurology.

Jong-Moo Park, MD, PhD, from Eulji University in Seoul, South Korea, and colleagues examined the effect of pre-stroke aspirin use on initial severity, hemorrhagic transformation, and functional outcome of ischemic stroke. They identified 10,433 patients with acute ischemic stroke (large artery atherosclerosis [LAA], small vessel occlusion [SVO], or cardioembolism [CE]) from a multicenter stroke registry database. They compared pre-stroke aspirin users and nonusers in terms of National Institutes of Health stroke scale (NIHSS), hemorrhagic transformation at presentation, and discharge modified Rankin scale (mRS).

The researchers found that 18.3% of patients reported pre-stroke aspirin use. Initial NIHSS scores of aspirin users were higher than nonusers on crude analysis (mean difference, 0.35). In multivariable analysis there was an interaction effect of pre-stroke aspirin use and stroke subtype, with aspirin users having less stroke severity than nonusers in LAA, but not SVO and CE (mean difference in NIHSS scores in LAA, −0.97). There were no significant interaction effects with respect to hemorrhagic transformation and mRS. Pre-stroke aspirin use correlated with increased risk of hemorrhagic transformation (adjusted odds ratio, 1.34) and with decreased risk of higher discharge mRS (adjusted odds ratio, 0.86).

“Pre-stroke aspirin use may reduce initial stroke severity in atherothrombotic stroke and can improve functional outcome at discharge,” the authors write.


  1. Park J-M, Kang K, Cho Y-J, et al. Comparative effectiveness of pre-stroke aspirin on stroke severity and outcome. Ann Neurol. 2016; doi: 10.1002/ana.24602