Antiplatelet bleeds assessed
Aspirin does not increase the risk of recurring intracerebral haemorrhage (ICH) in some patients, according to a study published in Neurology (2006;66:206).
Researchers in the US followed 207 survivors of ICH and recorded the
use of antiplatelet drugs — mostly aspirin — and the outcome
of recurrent ICH. The results indicate that use of antiplatelet therapy
is not associated with a substantially increased risk of either lobar
or deep ICH (the two different types of ICH).
Patients who have had ICH may also be at risk of ischaemic cardiovascular
events, and clinicians need to assess whether antiplatelet treatment
is more clinically important than the risk of recurrent haemorrhage.
Accordingly, because the antiplatelet treatment group was not randomly
assigned, the results of the study need to be applied with caution. Indeed,
treating physicians may have appropriately avoided prescribing antiplatelets
based on their perceived higher risk of bleed.
Because only one patient was taking a non-aspirin antiplatelet agent,
the data can only provide insight into aspirin-treated patients and cannot
be extended to combination antiplatelet therapy.
An editorial commenting on the study advises that, in this setting, antiplatelet
drugs be used in “highly selected patients with a compelling indication
and with a relatively low risk of recurrent bleeding” (ibid, p162). |
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