Department of Neurosurgery, The Jintan Hospital Affiliated to Jiangsu University, Changzhou, Jiangsu, China.
Department of Neurosurgery, The Jintan Hospital Affiliated to Jiangsu University, Changzhou, Jiangsu, China.
World Neurosurg. 2020 Jun;138:299-308. doi: 10.1016/j.wneu.2020.01.120. Epub 2020 Mar 9.
To assess the association between aspirin use and risk of aneurysmal subarachnoid hemorrhage (aSAH).
A systematic search was performed in various databases updated on October 22, 2019. The heterogeneity test was performed for each outcome variable. Random-effect model and fixed-effect model were respectively conducted according to the heterogeneity statistics. Trial sequential analysis was used to control random errors.
Ten studies involving 1,107,616 patients were involved in this meta-analysis. No significant association was shown between aspirin users and non-aspirin users regarding the risk of aSAH (odds ratio [OR]: 0.981, 95% confidential interval [CI]: 0.773-1.312, P = 0.897]. The results of subgroup analyses indicated that the risk of aSAH was notably associated with a short-term use of aspirin (<3 months) (OR: 1.697, 95% CI: 1.175-2.452, P = 0.005), but not aspirin use for 3-12 months (OR: 1.026, 95% CI: 0.609-1.730, P = 0.922), 1-3 years (OR: 0.942, 95% CI: 0.660-1.346, P = 0.744), >3 years (OR: 0.892, 95% CI: 0.573-1.389, P = 0.612), ≤2 times per week (OR: 0.857, 95% CI: 0.560-1.313, P = 0.479), ≥3 times per week (OR: 1.104, 95% CI: 0.555-2.193, P = 0.778) and former use (OR: 1.029, 95% CI: 0.482-2.196, P = 0.941).
A short-term use of aspirin (<3 months) is associated with an elevated risk of aSAH, whereas the role of its long-term use in either decreasing or increasing the risk of aSAH still requires well-designed, large-scale randomized control trials for verification.
评估阿司匹林使用与蛛网膜下腔出血（aSAH）风险之间的关联。
系统检索了 2019 年 10 月 22 日更新的各种数据库。针对每个结局变量进行了异质性检验。根据异质性统计数据，分别采用随机效应模型和固定效应模型。采用试验序贯分析来控制随机误差。
本荟萃分析共纳入 1107616 例患者的 10 项研究。阿司匹林使用者与非阿司匹林使用者的 aSAH 风险无显著相关性（比值比[OR]：0.981，95%置信区间[CI]：0.773-1.312，P=0.897）。亚组分析结果表明，短期（<3 个月）使用阿司匹林与 aSAH 风险显著相关（OR：1.697，95%CI：1.175-2.452，P=0.005），但 3-12 个月（OR：1.026，95%CI：0.609-1.730，P=0.922）、1-3 年（OR：0.942，95%CI：0.660-1.346，P=0.744）、>3 年（OR：0.892，95%CI：0.573-1.389，P=0.612）、每周≤2 次（OR：0.857，95%CI：0.560-1.313，P=0.479）、每周>3 次（OR：1.104，95%CI：0.555-2.193，P=0.778）和既往使用（OR：1.029，95%CI：0.482-2.196，P=0.941）阿司匹林与 aSAH 风险无关。
短期（<3 个月）使用阿司匹林与 aSAH 风险升高相关，而其长期使用降低或增加 aSAH 风险的作用仍需要精心设计的大规模随机对照试验来验证。
