Effect of body weight on bleeding events of aspirin in ischemic stroke or transient ischemic attack patients

J Clin Pharm Ther. 2022 Oct;47(10):1684-1689. doi: 10.1111/jcpt.13722. Epub 2022 Jun 24.

Abstract

What is known and objectives: Bleeding is the most common adverse reaction to aspirin and can lead to drug discontinuation or even be life-threatening in the secondary prevention of stroke or transient ischemic attack. The aim of this study was to evaluate risk factors for bleeding adverse reaction of aspirin in ischemic stroke or transient ischemic attack.

Methods: This retrospective analysis included patients treated with aspirin (100 mg) as a secondary prevention for ischemic stroke or transient ischemic attack. The bleeding events that occurred during the first year were collected, including gastrointestinal, skin, nasal cavity, gum, and urinary tract bleeding events. Then, univariate and multivariate logistic regression analyses were used to identify independent factors associated with bleeding events of aspirin.

Results and discussion: A total of 578 patients were enrolled in this study, and 58 patients developed bleeding during the first year of secondary prevention. Body weight and combination with selective serotonin reuptake inhibitors were found to be significant risk factors for overall bleeding (p = 0.025 and 0.012). Body weight below 60 kg was a risk factor for overall bleeding and gastrointestinal bleeding events.

What is new and conclusion: Patients weighing less than 60 kg were at increased risk of bleeding with 100 mg aspirin for secondary prevention of cerebral infarction transient ischemic attack.

Keywords: aspirin; bleeding; body weight; ischemic stroke; transient ischemic attack.

MeSH terms

  • Aspirin / adverse effects
  • Body Weight
  • Clopidogrel
  • Drug Therapy, Combination
  • Hemorrhage / chemically induced
  • Hemorrhage / drug therapy
  • Humans
  • Ischemic Attack, Transient* / complications
  • Ischemic Attack, Transient* / drug therapy
  • Ischemic Attack, Transient* / prevention & control
  • Ischemic Stroke*
  • Platelet Aggregation Inhibitors / adverse effects
  • Retrospective Studies
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Stroke* / drug therapy
  • Stroke* / prevention & control
  • Ticlopidine / therapeutic use
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors
  • Serotonin Uptake Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin