Abstract
Objective: To determine if: 1.) daily aspirin use decreased the severity of acute ischemic strokes (AIS), and 2.) aspirin acts through the acetylation of human serum albumin, since aspirin is an acetylating agent.
Background: The US Preventive Services Task Force recommends low dose aspirin for primary prevention of cardiovascular disease (CVD) in adults aged 50–59 with an increased risk of CVD including stroke, no increased risk of bleeding, a life expectancy ≥10 years, and a willingness to take aspirin daily. Yet patients of all ages take aspirin daily.
Design/Methods: A convenience sample of AIS patients was obtained at a Comprehensive Stroke Center (2010–2011); plasma samples were collected prospectively and clinical data were abstracted. Patient characteristics were compared univariately by aspirin status (yes/no). Stroke severity (initial NIHSS) was compared by aspirin status and dose (no aspirin, ≤81mg, or >81mg) univariately and by ANCOVA to adjust for significant clinical characteristics (p<0.05). Acetylation of albumin was measured using HPLC coupled to mass spectrometry and was analyzed by aspirin status and dose.
Results: Of 73 AIS patients, 21 (28.8%) were taking aspirin. Patients on aspirin were more often male and had a lower initial NIHSS (p<0.05). The lower initial NIHSS appeared as a dose response trend in which patients taking no aspirin, ≤81mg, or >81mg had decreasing median NIHSS scores of 10, 6, and 4, respectively (p=0.01). The significant association between aspirin dose and stroke severity remained after adjusting for sex (p=0.02). No differences in the acetylation of albumin were detected when examined by aspirin status or dose.
Conclusions: Aspirin appears to decrease the severity of AIS in a dose response fashion. We were unable to observe the effect of aspirin in the acetylation of albumin. Acetylation of additional proteins will be studied in an attempt to identify patients who respond best to aspirin.
Disclosure: Dr. Jensen has nothing to disclose. Dr. Leonard has nothing to disclose. Dr. Bar-Or has nothing to disclose. Dr. Rael has nothing to disclose. Dr. Bartt has nothing to disclose. Dr. Wagner has received personal compensation for activities with Genentech as a speaker. Dr. Bar-Or has nothing to disclose.
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