Skip to main content
AAN.com
Brief Communications
April 12, 2004
Letter to the Editor

Antiplatelet drug discontinuation is a risk factor for ischemic stroke

April 13, 2004 issue
62 (7) 1187-1189

Abstract

Antiplatelet drugs (APD) are widely used in the prevention of ischemic cardio- and cerebrovascular diseases. The authors studied the frequency of stroke occurring after APD discontinuation, the cause of discontinuation, and the delay between APD disruption and stroke. Only 4.49% of strokes were related to a recent APD discontinuation, but all cases occurred between 6 and 10 days after drug discontinuation (p < 0.0001). This temporal pattern has biologic plausibility because the inhibited platelets circulate in the blood for about 10 days.

Get full access to this article

View all available purchase options and get full access to this article.

References

1.
Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. Br Med J. 2002; 324: 71–86.
2.
Siess W. Molecular mechanisms of platelet activation. Physiol Rev. 1989; 69: 58–178.
3.
Aguejouf O, Belougne-Malfatti E, Doutremepuich F, Belon P, Doutremepuich C. Thromboembolic complications several days after a single-dose administration of aspirin. Thromb Res. 1998; 89: 123–127.
4.
Aguejouf O, Malfatti E, Belon P, Doutremepuich C. Time related neutralization of two doses acetyl salicylic acid. Thromb Res. 2000; 100: 317–323.
5.
McManus LM, Hanahan DJ, Pinckard RN. Human platelet stimulation by acetyl glyceryl ether phosphorylcholine. J Clin Invest. 1981; 67: 903–906.
6.
Alam M, Goldberg LH. Serious adverse vascular events associated with perioperative interruption of antiplatelet and anticoagulant therapy. Dermatol Surg. 2002; 28: 992–998.
7.
Katz J, Feldman MA, Bass EB, et al. Risks and benefits of anticoagulant and antiplatelet medication use before cataract surgery. Ophthalmology. 2003; 110: 1784–1788.
8.
Sacco RL. Risk factors, outcomes, and stroke subtypes for ischemic stroke. Neurology. 1997; 49: S39–S44.
Letters to the Editor
8 June 2004
Reply to Bachman
I. Sibon, Service de Neurologie, CHU Pellegrin

We thank Dr Bachman for calling our attention to his letter on antiplatelet drug disruption . [1] We did not reference this in our discussion but failed to identify it in our literature review. However, we believe that defining its content as "virtually the same information" is an overstatement.

The letter by Dr Bachman anecdotally describes 13 cases, not systematically screened, from an undefined population of ischemic strokes. The delay between aspirin discontinuation and the associated ischemic strokes, which is the key point of our paper [2] is not specified in three cases and was two weeks or more in seven cases. So we suspect that, in this series, a majority of cases may not be related to the aspirin discontinuation.

References

1). Bachman DS. Discontinuing chronic aspirin therapy: another risk factor for stroke? Ann Neurol. 2002;51:137-8.

2). Sibon I, Orgogozo JM. Antiplatelet drug discontinuation is a risk factor for ischemic stroke. Neurology. 2004 13;62:1187-1189.

8 June 2004
Antiplatelet drug discontinuation is a risk factor for ischemic stroke
David S. Bachman MD, Wilmington Health
Wilmington, NC 28401

Regarding the recent paper reporting the risk of stopping antiplatelet drugs [1], I reported virtually the same information in the Annals in 2001, including a Title and a Table of cases which are quite similar to the current publication. [2].

References

1) Sibon I and Orgogozo J. Antiplatelet drug discontinuation is a risk factor for ischemic stroke Neurology 2004; 62: 1187-1189.

2) Bachman D. Discontinuing Chronic Aspirin Therapy: Another risk factor for stroke? Ann Neurol 2002; 51:137-138.

Information & Authors

Information

Published In

Neurology®
Volume 62Number 7April 13, 2004
Pages: 1187-1189
PubMed: 15079022

Publication History

Received: August 25, 2003
Accepted: November 26, 2003
Published online: April 12, 2004
Published in print: April 13, 2004

Permissions

Request permissions for this article.

Authors

Affiliations & Disclosures

Igor Sibon, MD
From the Fédération de neurosciences cliniques, CHU Bordeaux, France.
Jean-Marc Orgogozo, MD
From the Fédération de neurosciences cliniques, CHU Bordeaux, France.

Notes

Address correspondence and reprint requests to Dr. I. Sibon, Service de neurologie, CHU Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux cedex, France; e-mail: [email protected]

Metrics & Citations

Metrics

Citations

Download Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.

Cited By
  1. Pharmacogenetics and Pharmacogenomics Impact on Aspirin Response, Pharmacogenomics and Pharmacogenetics in Drug Therapy, (2024).https://doi.org/10.5772/intechopen.113026
    Crossref
  2. Perioperative cardiac risk reduction in non cardiac surgery, Minerva Medica, 114, 6, (2024).https://doi.org/10.23736/S0026-4806.23.08474-4
    Crossref
  3. Management Options for Bleeding Hemorrhoids in Patients on Anticoagulation, Difficult Decisions in Colorectal Surgery, (483-490), (2024).https://doi.org/10.1007/978-3-031-42303-1_42
    Crossref
  4. Aspirin use and bleeding events during thrombocytopenia after autologous stem-cell transplantation for multiple myeloma, Frontiers in Oncology, 13, (2023).https://doi.org/10.3389/fonc.2023.1168120
    Crossref
  5. The machine learning methods to analyze the using strategy of antiplatelet drugs in ischaemic stroke patients with gastrointestinal haemorrhage, BMC Neurology, 23, 1, (2023).https://doi.org/10.1186/s12883-023-03422-0
    Crossref
  6. Complications of Spinal Cord Stimulator Trials and Implants: A Review, Current Pain and Headache Reports, 27, 12, (837-842), (2023).https://doi.org/10.1007/s11916-023-01190-7
    Crossref
  7. Predictors of long‐term medication adherence in stroke survivors: A multicentre, prospective, longitudinal study, Journal of Clinical Nursing, 32, 1-2, (58-70), (2022).https://doi.org/10.1111/jocn.16472
    Crossref
  8. Complete omission of second-look endoscopy after gastric endoscopic submucosal dissection in real-world practice, Medicine, 101, 28, (e29386), (2022).https://doi.org/10.1097/MD.0000000000029386
    Crossref
  9. No rebound effect after a course of clopidogrel in patients with acute TIA or minor stroke, Neurological Research, 44, 11, (957-963), (2022).https://doi.org/10.1080/01616412.2022.2075660
    Crossref
  10. Outcomes of Postprocedural Closeout Checklist Implementation to Prevent Adverse Events during Interventional Radiology Procedures: An Initiative to Improve Outcomes, Journal of Vascular and Interventional Radiology, 33, 10, (1240-1246), (2022).https://doi.org/10.1016/j.jvir.2022.06.023
    Crossref
  11. See more
Loading...

View Options

Get Access

Login options

Check if you have access through your login credentials or your institution to get full access on this article.

Personal login Institutional Login
Purchase Options

The neurology.org payment platform is currently offline. Our technical team is working as quickly as possible to restore service.

If you need immediate support or to place an order, please call or email customer service:

  • 1-800-638-3030 for U.S. customers - 8:30 - 7 pm ET (M-F)
  • 1-301-223-2300 for customers outside the U.S. - 8:30 - 7 pm ET (M-F)
  • [email protected]

We appreciate your patience during this time and apologize for any inconvenience.

View options

Full Text

View Full Text

Full Text HTML

View Full Text HTML

Media

Figures

Other

Tables

Share

Share

Share article link

Share