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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EDaily aspirin was ineffective for primary prevention of stroke in Japanese patients aged \u0026gt;\u200960 years with vascular risk factors, consistent with earlier findings that aspirin had no significant effect on composite cardiovascular outcomes, according to findings from the Japanese Primary Prevention Project.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Estroke\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Easpirin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Etransient ischemic attack\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiovascular\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EJapanese Primary Prevention Project\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EDaily aspirin does not significantly reduce the risk of a first fatal or nonfatal stroke in older patients with vascular risk factors. Shinichiro Uchiyama, MD, PhD, International University of Health and Welfare, Sanno Hospital and Sanno Medical Center, Tokyo, Japan, presented an analysis of the effect of aspirin for primary prevention of stroke in the Japanese Primary Prevention Project (JPPP) [Ikeda Y et al. \u003Cem\u003EJAMA.\u003C\/em\u003E 2014].\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EThe effect of aspirin on the primary prevention of stroke varies among clinical trials conducted in Western countries, and no data have been available on the effect of aspirin in an Asian population, which is at higher risk of intracranial hemorrhage than a white population.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EJPPP included 14\u003Cem\u003E\u2009\u003C\/em\u003E464 Japanese patients aged 60 to 85 years (mean age, 70 years) who presented with hypertension, dyslipidemia, or diabetes [Ikeda Y et al. \u003Cem\u003EJAMA.\u003C\/em\u003E 2014]. Patients were randomized 1to 1 to receive aspirin 100 mg once daily or no aspirin, in addition to ongoing medications. Follow-up was a median of 5.02 years, with a maximum follow-up of 6.5 years.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EThe primary end point was a composite of death from cardiovascular causes (myocardial infarction, stroke, and other cardiovascular causes), nonfatal stroke (ischemic or hemorrhagic, including undefined cerebrovascular events), and nonfatal myocardial infarction.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EThe main results of JPPP showed no significant effect of aspirin on the primary composite end point (HR, 0.94; 95% CI, 0.77 to 1.15; \u003Cem\u003EP\u2009\u003C\/em\u003E=\u2009.54). The prevalence of risk factors in the aspirin and no aspirin groups at baseline are shown in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15254\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15254\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15254\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EPatient Characteristics and Risk Factors at Baseline in JPPP\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EIn the analysis, the number of fatal and nonfatal strokes was 128 in each group. In analyzing the data further however, the type of stroke that occurred did vary, depending on the use or non-use of aspirin. Ischemic stroke was less frequent in the aspirin vs no aspirin group (85 vs 102), but hemorrhagic stroke was more common in the aspirin group (38 vs 23). Additionally, the number of transient ischemic attacks (TIAs) was nearly half that in the aspirin vs no aspirin group (19 vs 34).\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003EThe cumulative rate of any stroke or TIA at 5 years was not different between the groups (adjusted HR, 0.927; 95% CI, 0.741 to 1.60; \u003Cem\u003EP\u2009\u003C\/em\u003E=\u2009.509). The cumulative rate of any stroke at 5 years was also not significantly different (adjusted HR, 1.011:95% CI, 0.791 to 1.291; \u003Cem\u003EP\u2009\u003C\/em\u003E=\u2009.932).\u003C\/p\u003E\n         \u003Cp id=\u0022p-12\u0022\u003EThe rate of ischemic stroke was lower in the aspirin vs no aspirin group, although this difference failed to achieve significance (adjusted HR, 0.842; 95% CI, 0.631 to 1.123; \u003Cem\u003EP\u2009\u003C\/em\u003E=\u2009.240).\u003C\/p\u003E\n         \u003Cp id=\u0022p-13\u0022\u003ECerebral hemorrhage was almost twice as common in the aspirin vs no aspirin group (28 vs 15, respectively), while the rates of subarachnoid hemorrhage, subdural hematoma, and other hemorrhage were comparable. The cumulative rate of intracranial hemorrhage was not significantly different between the groups (adjusted HR, 1.463; 95% CI, 0.956 to 2.237; \u003Cem\u003EP\u2009\u003C\/em\u003E=\u2009.078). Significant risk factors for cerebrovascular events are listed in \u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15255\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15255\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15255\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \n               \u003Cp id=\u0022p-14\u0022 class=\u0022first-child\u0022\u003ESignificant Risk Factors for Cerebrovascular Events by Cox Regression Analysis\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-15\u0022\u003EThe rate of any stroke or TIA was not significantly different between patients randomized to aspirin or no aspirin in the low-risk or the high-risk groups based on a stroke risk score.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/2\/12.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlqsd\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlqsd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}