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Aspirin and Subarachnoid Haemorrhage in the UK Biobank

Aspirin and Subarachnoid Haemorrhage in the UK Biobank
Aspirin and Subarachnoid Haemorrhage in the UK Biobank

Previous studies investigating the relationship between aspirin use and subarachnoid haemorrhage (SAH) have yielded conflicting results. In this study, we aimed to clarify the association between aspirin and SAH in the general population. The UK Biobank is a prospective population-based cohort study. Sex, age, smoking, alcohol, medication use, hypertension, blood pressure, ischaemic heart disease and stroke were recorded at baseline assessments. Follow-up is conducted through linkages to National Health Service data including electronic, coded death certificate, hospital and primary care data. Cox proportional hazards modelling was used to analyse the association between aspirin use and SAH. Of the 501,060 participants included in the analysis, a total of 579 suffered from spontaneous SAH after their baseline assessment. There was no relationship between aspirin and SAH of all causes (HR, 1.16 [0.92–1.46]), aneurysmal SAH (HR, 1.15 [0.91–1.47]) or non-aneurysmal SAH (HR, 1.29 [0.54–3.09]). Aspirin use was associated with SAH resulting in death (HR, 1.69 [1.14–2.51]), especially out of hospital death (HR, 2.10 [1.13–3.91]). Despite reports of a protective association between aspirin and SAH in patients with known unruptured aneurysms, this study has not demonstrated the same effect in the general population. However, aspirin users were more likely to suffer SAH resulting in death, especially out of hospital.

Antiplatelet therapy, Aspirin, Stroke, Stroke prevalence, Stroke subtypes, Subarachnoid haemorrhage
1868-601X
Ewbank, Frederick
70a00611-6654-4016-9be7-cd7bbc9d4a4d
Birks, Jacqueline
af86a0f6-e264-48e6-a931-f0ffc091be1e
Gaastra, Ben
c7b7f371-706b-4d59-9150-94e8f254e205
Hall, Samuel
703c2f84-ad99-4211-9408-307bbb59732c
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Bulters, Diederik
d6f9644a-a32f-45d8-b5ed-be54486ec21d
Ewbank, Frederick
70a00611-6654-4016-9be7-cd7bbc9d4a4d
Birks, Jacqueline
af86a0f6-e264-48e6-a931-f0ffc091be1e
Gaastra, Ben
c7b7f371-706b-4d59-9150-94e8f254e205
Hall, Samuel
703c2f84-ad99-4211-9408-307bbb59732c
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Bulters, Diederik
d6f9644a-a32f-45d8-b5ed-be54486ec21d

Ewbank, Frederick, Birks, Jacqueline, Gaastra, Ben, Hall, Samuel, Galea, Ian and Bulters, Diederik (2022) Aspirin and Subarachnoid Haemorrhage in the UK Biobank. Translational Stroke Research. (doi:10.1007/s12975-022-01060-1).

Record type: Article

Abstract

Previous studies investigating the relationship between aspirin use and subarachnoid haemorrhage (SAH) have yielded conflicting results. In this study, we aimed to clarify the association between aspirin and SAH in the general population. The UK Biobank is a prospective population-based cohort study. Sex, age, smoking, alcohol, medication use, hypertension, blood pressure, ischaemic heart disease and stroke were recorded at baseline assessments. Follow-up is conducted through linkages to National Health Service data including electronic, coded death certificate, hospital and primary care data. Cox proportional hazards modelling was used to analyse the association between aspirin use and SAH. Of the 501,060 participants included in the analysis, a total of 579 suffered from spontaneous SAH after their baseline assessment. There was no relationship between aspirin and SAH of all causes (HR, 1.16 [0.92–1.46]), aneurysmal SAH (HR, 1.15 [0.91–1.47]) or non-aneurysmal SAH (HR, 1.29 [0.54–3.09]). Aspirin use was associated with SAH resulting in death (HR, 1.69 [1.14–2.51]), especially out of hospital death (HR, 2.10 [1.13–3.91]). Despite reports of a protective association between aspirin and SAH in patients with known unruptured aneurysms, this study has not demonstrated the same effect in the general population. However, aspirin users were more likely to suffer SAH resulting in death, especially out of hospital.

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e-pub ahead of print date: 9 July 2022
Published date: 9 July 2022
Additional Information: Funding Information: Jacqueline Birks is funded by NIHR Biomedical Research Centre (BRC), Oxford University Hospitals NHS Foundation Trust. Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Keywords: Antiplatelet therapy, Aspirin, Stroke, Stroke prevalence, Stroke subtypes, Subarachnoid haemorrhage

Identifiers

Local EPrints ID: 470409
URI: http://eprints.soton.ac.uk/id/eprint/470409
ISSN: 1868-601X
PURE UUID: 570323bb-feb9-4473-a2ad-0e2ac5992f6c
ORCID for Ben Gaastra: ORCID iD orcid.org/0000-0002-7517-6882
ORCID for Ian Galea: ORCID iD orcid.org/0000-0002-1268-5102
ORCID for Diederik Bulters: ORCID iD orcid.org/0000-0001-9884-9050

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Date deposited: 10 Oct 2022 16:48
Last modified: 11 Oct 2022 02:03

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Contributors

Author: Frederick Ewbank
Author: Jacqueline Birks
Author: Ben Gaastra ORCID iD
Author: Samuel Hall
Author: Ian Galea ORCID iD
Author: Diederik Bulters ORCID iD

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