Aspirin as a promising agent for decreasing incidence of cerebral aneurysm rupture

David M. Hasan, Kelly B. Mahaney, Robert D Jr. Brown, Irene Meissner, David G. Piepgras, John III Huston, Ana W. Capuano, James C. Torner

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE-: Chronic inflammation is postulated as an important phenomenon in intracranial aneurysm wall pathophysiology. This study was conducted to determine if aspirin use impacts the occurrence of intracranial aneurysm rupture. METHODS-: Subjects enrolled in the International Study of Unruptured Intracranial Aneurysms (ISUIA) were selected from the prospective untreated cohort (n=1691) in a nested case-control study. Cases were subjects who subsequently had a proven aneurysmal subarachnoid hemorrhage during a 5-year follow-up period. Four control subjects were matched to each case by site and size of aneurysm (58 cases, 213 control subjects). Frequency of aspirin use was determined at baseline interview. Aspirin frequency groups were analyzed for risk of aneurysmal hemorrhage. Bivariable and multivariable analyses were performed using conditional logistic regression. RESULTS-: A trend of a protective effect for risk of unruptured intracranial aneurysm rupture was observed. Patients who used aspirin 3× weekly to daily had an OR for hemorrhage of 0.40 (95% CI, 0.18-0.87); reference group, no use of aspirin), patients in the "< once a month" group had an OR of 0.80 (95% CI, 0.31-2.05), and patients in the "> once a month to 2×/week" group had an OR of 0.87 (95% CI, 0.27-2.81; P=0.025). In multivariable risk factor analyses, patients who used aspirin 3 times weekly to daily had a significantly lower odds of hemorrhage (adjusted OR, 0.27; 95% CI, 0.11-0.67; P=0.03) compared with those who never take aspirin. CONCLUSIONS-: Frequent aspirin use may confer a protective effect for risk of intracranial aneurysm rupture. Future investigation in animal models and clinical studies is needed.

Original languageEnglish (US)
Pages (from-to)3156-3162
Number of pages7
JournalStroke
Volume42
Issue number11
DOIs
StatePublished - Nov 2011

Fingerprint

Intracranial Aneurysm
Aspirin
Rupture
Incidence
Hemorrhage
Subarachnoid Hemorrhage
Statistical Factor Analysis
Aneurysm
Case-Control Studies
Animal Models
Logistic Models
Interviews
Inflammation

Keywords

  • aspirin
  • hemorrhage
  • inflammation
  • rupture
  • unruptured aneurysm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Aspirin as a promising agent for decreasing incidence of cerebral aneurysm rupture. / Hasan, David M.; Mahaney, Kelly B.; Brown, Robert D Jr.; Meissner, Irene; Piepgras, David G.; Huston, John III; Capuano, Ana W.; Torner, James C.

In: Stroke, Vol. 42, No. 11, 11.2011, p. 3156-3162.

Research output: Contribution to journalArticle

Hasan, David M. ; Mahaney, Kelly B. ; Brown, Robert D Jr. ; Meissner, Irene ; Piepgras, David G. ; Huston, John III ; Capuano, Ana W. ; Torner, James C. / Aspirin as a promising agent for decreasing incidence of cerebral aneurysm rupture. In: Stroke. 2011 ; Vol. 42, No. 11. pp. 3156-3162.
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AU - Hasan, David M.

AU - Mahaney, Kelly B.

AU - Brown, Robert D Jr.

AU - Meissner, Irene

AU - Piepgras, David G.

AU - Huston, John III

AU - Capuano, Ana W.

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N2 - BACKGROUND AND PURPOSE-: Chronic inflammation is postulated as an important phenomenon in intracranial aneurysm wall pathophysiology. This study was conducted to determine if aspirin use impacts the occurrence of intracranial aneurysm rupture. METHODS-: Subjects enrolled in the International Study of Unruptured Intracranial Aneurysms (ISUIA) were selected from the prospective untreated cohort (n=1691) in a nested case-control study. Cases were subjects who subsequently had a proven aneurysmal subarachnoid hemorrhage during a 5-year follow-up period. Four control subjects were matched to each case by site and size of aneurysm (58 cases, 213 control subjects). Frequency of aspirin use was determined at baseline interview. Aspirin frequency groups were analyzed for risk of aneurysmal hemorrhage. Bivariable and multivariable analyses were performed using conditional logistic regression. RESULTS-: A trend of a protective effect for risk of unruptured intracranial aneurysm rupture was observed. Patients who used aspirin 3× weekly to daily had an OR for hemorrhage of 0.40 (95% CI, 0.18-0.87); reference group, no use of aspirin), patients in the "< once a month" group had an OR of 0.80 (95% CI, 0.31-2.05), and patients in the "> once a month to 2×/week" group had an OR of 0.87 (95% CI, 0.27-2.81; P=0.025). In multivariable risk factor analyses, patients who used aspirin 3 times weekly to daily had a significantly lower odds of hemorrhage (adjusted OR, 0.27; 95% CI, 0.11-0.67; P=0.03) compared with those who never take aspirin. CONCLUSIONS-: Frequent aspirin use may confer a protective effect for risk of intracranial aneurysm rupture. Future investigation in animal models and clinical studies is needed.

AB - BACKGROUND AND PURPOSE-: Chronic inflammation is postulated as an important phenomenon in intracranial aneurysm wall pathophysiology. This study was conducted to determine if aspirin use impacts the occurrence of intracranial aneurysm rupture. METHODS-: Subjects enrolled in the International Study of Unruptured Intracranial Aneurysms (ISUIA) were selected from the prospective untreated cohort (n=1691) in a nested case-control study. Cases were subjects who subsequently had a proven aneurysmal subarachnoid hemorrhage during a 5-year follow-up period. Four control subjects were matched to each case by site and size of aneurysm (58 cases, 213 control subjects). Frequency of aspirin use was determined at baseline interview. Aspirin frequency groups were analyzed for risk of aneurysmal hemorrhage. Bivariable and multivariable analyses were performed using conditional logistic regression. RESULTS-: A trend of a protective effect for risk of unruptured intracranial aneurysm rupture was observed. Patients who used aspirin 3× weekly to daily had an OR for hemorrhage of 0.40 (95% CI, 0.18-0.87); reference group, no use of aspirin), patients in the "< once a month" group had an OR of 0.80 (95% CI, 0.31-2.05), and patients in the "> once a month to 2×/week" group had an OR of 0.87 (95% CI, 0.27-2.81; P=0.025). In multivariable risk factor analyses, patients who used aspirin 3 times weekly to daily had a significantly lower odds of hemorrhage (adjusted OR, 0.27; 95% CI, 0.11-0.67; P=0.03) compared with those who never take aspirin. CONCLUSIONS-: Frequent aspirin use may confer a protective effect for risk of intracranial aneurysm rupture. Future investigation in animal models and clinical studies is needed.

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