Department of Neurosurgery, University Hospital Southampton, Southampton, UK.
Centre for Statistics in Medicine, University of Oxford, Oxford, UK.
Sci Rep. 2023 Apr 21;13(1):6533. doi: 10.1038/s41598-023-33570-9.
Studies investigating the association between acetylsalicylic acid (ASA) use and spontaneous subarachnoid haemorrhage (SAH) in the general population have produced conflicting results. The aim of this study is to clarify the relationship between SAH and ASA. We included all participants who reported on ASA use during interim examinations of the Framingham Heart Study Cohorts. Using Cox proportional-hazards regression modelling, we estimated the hazard ratio (HR) associated with ASA use. 7692 participants were included in this study. There were 30 cases of SAH during follow up, with an estimated incidence of 10.0 per 100,000 person- years (CI 6.90-14.15). Univariate analysis showed no association between regular ASA use and SAH (HR, 0.33 [0.08-1.41]; p = 0.14). This was similar when accounting for smoking (HR, 0.35 [0.08-1.51]; p = 0.16). Using a large longitudinal dataset from the Framingham Heart Study, we observed some evidence suggesting fewer SAH in those participants taking regular ASA. However, multivariate statistical analysis showed no significant association between ASA use and SAH. Due to the low incidence of SAH in the general population, the absolute number of SAH events was low and it remains uncertain if a significant effect would become apparent with more follow up.
在一般人群中，研究阿司匹林（ASA）使用与自发性蛛网膜下腔出血（SAH）之间的关系产生了相互矛盾的结果。本研究旨在阐明 SAH 与 ASA 之间的关系。我们纳入了所有在弗雷明汉心脏研究队列的中期检查中报告使用 ASA 的参与者。我们使用 Cox 比例风险回归模型估计了与 ASA 使用相关的风险比（HR）。本研究共纳入了 7692 名参与者。在随访期间发生了 30 例 SAH，估计发病率为每 100000 人年 10.0 例（95%CI 6.90-14.15）。单因素分析显示，常规使用 ASA 与 SAH 之间无关联（HR，0.33 [0.08-1.41]；p=0.14）。当考虑吸烟因素时，结果相似（HR，0.35 [0.08-1.51]；p=0.16）。使用弗雷明汉心脏研究的大型纵向数据集，我们观察到一些证据表明，定期服用 ASA 的参与者发生 SAH 的可能性较低。然而，多变量统计分析显示 ASA 使用与 SAH 之间无显著关联。由于一般人群中 SAH 的发病率较低，SAH 事件的绝对数量较低，因此尚不确定随着随访时间的延长，是否会出现明显的效果。
