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Intracranial Hemorrhage Risk Up With Low-Dose Aspirin

FRIDAY, May 24, 2019 -- For individuals without symptomatic cardiovascular disease, the use of low-dose aspirin for primary prevention of cardiovascular events is associated with an increased risk for intracranial hemorrhage, according to a review and meta-analysis published online May 13 in JAMA Neurology.

Wen-Yi Huang, M.D., Ph.D., from Chang Gung Memorial Hospital in Puzi, Taiwan, and colleagues examined the risk for intracranial hemorrhage associated with low-dose aspirin among individuals without symptomatic cardiovascular disease. Thirteen randomized clinical trials of low-dose aspirin use for primary prevention, with 134,446 patients, were included in the analysis.

The researchers found that compared with control, low-dose aspirin was associated with an increased risk for any intracranial bleeding (eight trials; relative risk, 1.37), with potentially the greatest relative risk increase for subdural or extradural hemorrhage (four trials: relative risk, 1.53); for intracerebral hemorrhage and subarachnoid hemorrhage, there was less of an increase. Asian race/ethnicity and low body mass index were associated with heightened risk for intracerebral hemorrhage with low-dose aspirin versus control.

"Because the benefits of low-dose aspirin for primary prevention of cardiovascular events are not well established, and the outcomes of intracranial hemorrhage are often catastrophic, these findings suggest caution regarding using low-dose aspirin in individuals without symptomatic cardiovascular disease," the authors write.

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Posted: May 2019

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