• Sanne M Zinkstok, Ludo F Beenen, Charles B Majoie, Henk A Marquering, Rob J de Haan, and Yvo B Roos.
• From the Departments of Neurology (S.M.Z., Y.B.R.), Radiology (L.F.B., C.B.M., H.A.M.), Biomedical Engineering and Physics (H.A.M.), and the Clinical Research Unit (R.J.d.H.), Academic Medical Center University, Amsterdam, The Netherlands.
• Stroke. 2014 Oct 1;45(10):3080-2.

Background And PurposeAspirin early after intravenous thrombolysis in acute ischemic stroke increases the risk of symptomatic intracranial hemorrhage (SICH), without influencing functional outcome at 3 months. The effect of aspirin on early neurological deterioration (END) was explored as a post hoc analysis of the randomized Antiplatelet Therapy in Combination With Recombinant t-PA Thrombolysis in Ischemic Stroke (ARTIS) trial.MethodsEND, defined as a ≥4 points National Institutes of Health Stroke Scale worsening ≤24 hours after intravenous thrombolysis, was categorized into SICH (ENDSICH) and cerebral ischemia (ENDCI). Multinomial logistic regression was used to assess the effect of aspirin on END.ResultsOf the 640 patients, 31 patients (4.8%) experienced END (14 ENDSICH, 17 ENDCI). Aspirin increased the risk of ENDSICH (odds ratio, 3.73; 95% confidence interval, 1.03-13.49) but not of ENDCI (odds ratio, 1.14; 95% confidence interval, 0.44-3.00). After adjustment for other explanatory variables, the association between aspirin and ENDSICH remained significant.ConclusionsIn this trial, there is no evidence of an early antithrombotic effect from the addition of aspirin to intravenous thrombolysis in acute ischemic stroke.© 2014 American Heart Association, Inc.

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