stroke group had discontinued aspirin within four weeks before their stroke, while only four patients did in the control group. Therefore, patients with stroke or TIA were 3.25 times more likely to have interrupted their aspirin than patients with similar risk factors but no new stroke or TIA. Seventy-seven percent of the ischemic strokes related to aspirin discontinuation occurred in the first eight days after aspirin was stopped; the other 23 percent occurred from day nine to 30.
"Although the absolute risk of suffering a substantial stroke during a short period of aspirin discontinuation is probably not very high, this difference is meaningful, and patients and physicians should be informed about this potential risk," Michel said.
About one-third of patients in the study group discontinued aspirin themselves because of minor bleeding or lack of compliance. In about two-thirds of patients, physicians had ordered aspirin discontinuation for minor bleeding or minor surgical procedures.
The current literature suggests that many diagnostic or surgical procedures, such as cataract surgery or dermatological procedures, may be safely performed while the patient is taking low-dose aspirin.
Michel said a prospective, controlled, randomized trial should be conducted to prove exactly what the stroke risk is from discontinuing aspirin use. He said that such a trial should be a cooperative effort between neurologists, general practitioners, and sub-specialists doing diagnostic and surgical procedures for which aspirin is often discontinued.
Lead author on the study is Alexandre Maulaz, M.D. Other co-authors are Daniel Bezerra, M.D.; Bartolomeij Piechowski-Joywiak, M.D.; and Julien Bogousslavsky, M.D.
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Contact: Carole Bullock
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