Safety of Aspirin Use in Patients With Stroke and Small Unruptured Aneurysms.

Objective We initiated a multicenter, prospective cohort study to test the hypothesis that aspirin is safe for patients with ischemic cerebrovascular disease (ICVD) harboring unruptured intracranial aneurysms (UIAs) Methods This prospective, multicenter cohort study consecutively enrolled 1866 eligible patients with ICVD harboring UIAs Results After a total of 4,411.4 person-years, 643 (37.2%) patients continuously received aspirin treatment. Of all included patients, rupture occurred in 12 (0.7%). The incidence rate for rupture (IRR) was 0.27 (95% CI 0.15–0.48) per 100 person-years. The IRRs were 0.39 (95% CI 0.21–0.72) and 0.06 (95% CI 0.010–0.45) per 100 person-years for the nonaspirin and aspirin groups, respectively. In the multivariate analysis, uncontrolled hypertension and UIAs 5 to Conclusion Aspirin is a safe treatment for patients with concurrent small UIAs and ICVD. Patients that are not taking aspirin in the high-risk group warrant intensive surveillance. ClinicalTrials.gov identifier NCT02846259. Classification of evidence This study provides Class III evidence that for patients harboring UIAs