Title: Aspirin and Acute Ischemic Stroke

Category: Neurology

Keywords: aspirin, acute ischemic stroke, stroke (PubMed Search)

Posted: 6/29/2011 by Aisha Liferidge, MD (Updated: 3/10/2026)

Don't forget to give aspirin to patients presenting with acute ischemic stroke (AIS).

Large trials such as the International Stroke Trial (IST) and Chinese Acute Stroke Trial (CAST) have shown that starting 160 to 300 mg of aspirin within 48 hours of the presumed onset of ischemic stroke reduces the risk of early recurrent ischemic stroke, with no major increased risk of hemorrhagic conversion and with improved long-term outcome.

Studies have also shown that high and low doses of aspirin (30 to 1200 mg per day) after AIS yield similar efficacy for preventing vascular events, but that higher doses are associated with a greater risk of gastrointestinal hemorrhage.

Chen ZM, et al. Indications for early aspirin use in acute ischemic stroke : A combined analysis of 40 000 randomized patients from the chinese acute stroke trial and the international stroke trial. On behalf of the CAST and IST collaborative groups. Stroke. 2000;31(6):1240.
Farrell B, et al. The United Kingdom Transient Ischaemic Attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychiatry. 1991; 54: 1044–1054.
The Dutch TIA trial: protective effects of low-dose aspirin and atenolol in patients with transient ischemic attacks or nondisabling stroke: the Dutch TIA Study Group. Stroke. 1988; 19: 512–517.