Effect Of Premorbid Antiplatelet Use On Stroke Severity And Ischemic Stroke Outcomes

Background and Objective:Ischemic stroke has high morbidity, mortality, mutilation rate and the recurrence rateand has already became a common diseases of the public health, and actively research it，smechanism and the process of the pathophysiological change and give the patientstreatment as soon as possible to the occurrence of ischemic stroke, reduce the severity ofthe disease and improve the outcome has important significance. At present, someresearches have displayed the application of antiplatelet drugs to prevent the occurrence ofischemic stroke, reduce the incidence of recurrence rate of ischemic stroke, but the effectof premorbid antiplatelet use on stroke severity and ischemic stroke outcomes is stilldisputed. To evaluate the effect of premorbid antiplatelet aspirin use on acute ischemicstroke severity and outcome according to the stroke classification. Furthermore, to studythe mechanism of ischemic stroke, and to search for beneficial evidence of application ofantiplatelet drugs for ischemic stroke in prevention and treatment.Methods:A total of238patients with acute ischemic stroke presented within24hours fromsymptoms’ onset were selected from November2010to September2011, after thoseclassified into stroke of other determined etiologies or undetermined etiology wereexcluded. These patients were sub-divided into Aspirin-inclusive (AI) and no Aspirin (NA)group according to previous aspirin use dosage≥50mg/day or not in the7days before theirstroke. Stroke severity was measured using the National Institutes of Health StrokeScale(NIHSS) at presentation and the functional outcomes at14days and3months wereevaluated by way of the modified Rankin scale score(mRS),while≤2represented goodand≥3bad outcome. The Mann-Whitney U test was used for the stroke severity, logisticregression was used for the functional outcomes at14days and at3months. Patientswithin3months recurrent also classified as bad outcome.Results: Of the total238patients, there were82cases in AI and156in NA group. The medianof NIHSS was significantly lower in AI group than in NA group (4.56vs5.38,P=0.036).Also the same result was obtained but only in patients with the large arteryatherosclerosis (LAA) subtype (P<0.001) according to TOAST criteria. However, afteradjusting for age, sex, history and NIHSS, no significance in the functional outcomesbetween these2groups was found either at14days(mRS；P=0.901) or3months(mRS；P=0.761). Furthermore, in patients assigned into the LAA subtype,previous aspirinuse was significantly corresponded with better outcomes at both14days(mRS；P=0.014OR=0.329) and3months(mRS；P=0.023OR=0.319).Conclusions:Previous aspirin use may be associated with reduced ischemic stroke severity,especially for the large-artery atherosclerosis subtype, and may improve functionaloutcomes of patients suffered from ischemic stroke with that subtype.