The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Anhui Provincial Children's Hospital, Hefei, China.
J Clin Pharm Ther. 2022 Oct;47(10):1684-1689. doi: 10.1111/jcpt.13722. Epub 2022 Jun 24.
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.
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.
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.
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.
出血是阿司匹林最常见的不良反应，可导致停药，甚至在中风或短暂性脑缺血发作的二级预防中危及生命。本研究旨在评估缺血性卒中和短暂性脑缺血发作患者使用阿司匹林后出血不良反应的相关风险因素。
本回顾性分析纳入了使用阿司匹林（100mg）进行缺血性卒中和短暂性脑缺血发作二级预防的患者。收集了第一年发生的出血事件，包括胃肠道、皮肤、鼻腔、牙龈和泌尿道出血事件。然后，采用单因素和多因素逻辑回归分析确定与阿司匹林出血事件相关的独立因素。
本研究共纳入 578 例患者，其中 58 例患者在二级预防的第一年发生出血。体重和与选择性 5-羟色胺再摄取抑制剂合用被发现是总体出血的显著危险因素（p=0.025 和 0.012）。体重低于 60kg 是总体出血和胃肠道出血事件的危险因素。
体重不足 60kg 的患者使用 100mg 阿司匹林进行脑梗死短暂性脑缺血发作二级预防时出血风险增加。
