Longitudinal Study on Low-Dose Aspirin versus Placebo Administration in Silent Brain Infarcts: The Silence Study

doi:10.1155/2018/7532403

. 2018 Oct 3:2018:7532403.

doi: 10.1155/2018/7532403. eCollection 2018.

Longitudinal Study on Low-Dose Aspirin versus Placebo Administration in Silent Brain Infarcts: The Silence Study

Ilaria Maestrini¹, Marta Altieri¹, Laura Di Clemente¹, Edoardo Vicenzini¹, Patrizia Pantano^{1

2}, Eytan Raz¹, Mauro Silvestrini³, Leandro Provinciali³, Isabella Paolino³, Carmine Marini⁴, Matteo Di Giuseppe⁴, Tommasina Russo⁴, Francesco Federico⁵, Cristiana Coppola⁵, Maria Pia Prontera⁵, Domenico Maria Mezzapesa⁵, Vincenzo Lucivero⁵, Lucilla Parnetti⁶, Paola Sarchielli⁶, Maria Peducci⁶, Domenico Inzitari⁷, Giovanna Carlucci⁷, Carlo Serrati⁸, Carla Zat⁹, Anna Cavallini¹⁰, Alessandra Persico¹⁰, Giuseppe Micieli¹⁰, Stefano Bastianello¹¹, Vittorio Di Piero¹

Affiliations

¹ Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy.
² IRCSS Neuromed, Pozzilli (IS), Italy.
³ Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
⁴ Department of Internal Medicine and Public Health, University of L'Aquila, L'Aquila, Italy.
⁵ Department of Neurology and Psychiatrics, University of Bari, Bari, Italy.
⁶ Neurologic Clinic, Department of Medical and Surgical Specialties and Public Health, University of Perugia, Perugia, Italy.
⁷ Department of NEUROFARBA, University of Florence, Florence, Italy.
⁸ Department of Neurology, IRCCS San Martino Hospital-IST, Genoa, Italy.
⁹ Neurological Division, Ospedale Civile di Imperia, Imperia, Italy.
¹⁰ Department of Cerebrovascular Diseases, Fondazione "Istituto Neurologico C. Mondino", Pavia, Italy.
¹¹ Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.

PMID: 30402216
PMCID: PMC6192130
DOI: 10.1155/2018/7532403

Longitudinal Study on Low-Dose Aspirin versus Placebo Administration in Silent Brain Infarcts: The Silence Study

Ilaria Maestrini et al. Stroke Res Treat. 2018.

. 2018 Oct 3:2018:7532403.

doi: 10.1155/2018/7532403. eCollection 2018.

Authors

Affiliations

¹ Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy.
² IRCSS Neuromed, Pozzilli (IS), Italy.
³ Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
⁴ Department of Internal Medicine and Public Health, University of L'Aquila, L'Aquila, Italy.
⁵ Department of Neurology and Psychiatrics, University of Bari, Bari, Italy.
⁶ Neurologic Clinic, Department of Medical and Surgical Specialties and Public Health, University of Perugia, Perugia, Italy.
⁷ Department of NEUROFARBA, University of Florence, Florence, Italy.
⁸ Department of Neurology, IRCCS San Martino Hospital-IST, Genoa, Italy.
⁹ Neurological Division, Ospedale Civile di Imperia, Imperia, Italy.
¹⁰ Department of Cerebrovascular Diseases, Fondazione "Istituto Neurologico C. Mondino", Pavia, Italy.
¹¹ Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.

PMID: 30402216
PMCID: PMC6192130
DOI: 10.1155/2018/7532403

Abstract

Background: We investigated low-dose aspirin (ASA) efficacy and safety in subjects with silent brain infarcts (SBIs) in preventing new cerebrovascular (CVD) events as well as cognitive impairment.

Methods: We included subjects aged ≥45 years, with at least one SBI and no previous CVD. Subjects were followed up to 4 years assessing CVD and SBI incidence as primary endpoint and as secondary endpoints: (a) cardiovascular and adverse events and (b) cognitive impairment.

Results: Thirty-six subjects received ASA while 47 were untreated. Primary endpoint occurred in 9 controls (19.1%) versus 2 (5.6%) in the ASA group (p=0.10). Secondary endpoints did not differ in the two groups. Only baseline leukoaraiosis predicts primary [OR 5.4 (95%CI 1.3-22.9, p=0.022)] and secondary endpoint-a [3.2 (95%CI 1.1-9.6, p=0.040)] occurrence.

Conclusions: These data show an increase of new CVD events in the untreated group. Despite the study limitations, SBI seems to be a negative prognostic factor and ASA preventive treatment might improve SBI prognosis. EU Clinical trial is registered with EudraCT Number: 2005-000996-16; Sponsor Protocol Number: 694/30.06.04.

PubMed Disclaimer

Cited by

ESO Guideline on covert cerebral small vessel disease.
Wardlaw JM, Debette S, Jokinen H, De Leeuw FE, Pantoni L, Chabriat H, Staals J, Doubal F, Rudilosso S, Eppinger S, Schilling S, Ornello R, Enzinger C, Cordonnier C, Taylor-Rowan M, Lindgren AG. Wardlaw JM, et al. Eur Stroke J. 2021 Jun;6(2):CXI-CLXII. doi: 10.1177/23969873211012132. Epub 2021 May 11. Eur Stroke J. 2021. PMID: 34414301 Free PMC article.
Oral antiplatelet therapy for acute ischaemic stroke.
Minhas JS, Chithiramohan T, Wang X, Barnes SC, Clough RH, Kadicheeni M, Beishon LC, Robinson T. Minhas JS, et al. Cochrane Database Syst Rev. 2022 Jan 14;1(1):CD000029. doi: 10.1002/14651858.CD000029.pub4. Cochrane Database Syst Rev. 2022. PMID: 35028933 Free PMC article.
Aspirin for Primary Stroke Prevention; Evidence for a Differential Effect in Men and Women.
Gdovinova Z, Kremer C, Lorenzano S, Dawson J, Lal A, Caso V. Gdovinova Z, et al. Front Neurol. 2022 Jun 21;13:856239. doi: 10.3389/fneur.2022.856239. eCollection 2022. Front Neurol. 2022. PMID: 35800088 Free PMC article. Review.
Management of covert brain infarction survey: A call to care for and trial this neglected population.
Meinel TR, Triulzi CB, Kaesmacher J, Mujanovic A, Pasi M, Leung LY, Kent DM, Sui Y, Seiffge D, Bücke P, Umarova R, Arnold M, Roten L, Nguyen TN, Wardlaw J, Fischer U. Meinel TR, et al. Eur Stroke J. 2023 Dec;8(4):1079-1088. doi: 10.1177/23969873231187444. Epub 2023 Jul 10. Eur Stroke J. 2023. PMID: 37427426 Free PMC article.
Diffusion-Weighted Imaging Lesions After Intracerebral Hemorrhage and Risk of Stroke: A MISTIE III and ATACH-2 Analysis.
Murthy SB, Zhang C, Gupta A, Cho SM, Rivera-Lara L, Avadhani R, Gruber J, Iadecola C, Falcone GJ, Sheth KN, Qureshi AI, Goldstein JN, Hanley DF, Kamel H, Ziai WC. Murthy SB, et al. Stroke. 2021 Jan;52(2):595-602. doi: 10.1161/STROKEAHA.120.031628. Epub 2021 Jan 20. Stroke. 2021. PMID: 33467877 Free PMC article. Clinical Trial.

See all "Cited by" articles

References

1. Kovács K. R., Czuriga D., Bereczki D., Bornstein N. M., Csiba L. Silent brain infarction - a review of recent observations. International Journal of Stroke. 2013;8(5):334–347. doi: 10.1111/j.1747-4949.2012.00851.x. - DOI - PubMed
1. Vermeer S. E., Hollander M., Van Dijk E. J., Hofman A., Koudstaal P. J., Breteler M. M. B. Silent brain infarcts and white matter lesions increase stroke risk in the general population: The Rotterdam Scan Study. Stroke. 2003;34(5):1126–1129. doi: 10.1161/01.STR.0000068408.82115.D2. - DOI - PubMed
1. Vermeer S. E., Prins N. D., den Heijer T., Hofman A., Koudstaal P. J., Breteler M. M. B. Silent brain infarcts and the risk of dementia and cognitive decline. The New England Journal of Medicine. 2003;348(13):1215–1222. doi: 10.1056/nejmoa022066. - DOI - PubMed
1. Debette S., Beiser A., Decarli C., et al. Association of MRI markers of vascular brain injury with incident stroke, mild cognitive impairment, dementia, and mortality: The framingham offspring study. Stroke. 2010;41(4):600–606. doi: 10.1161/STROKEAHA.109.570044. - DOI - PMC - PubMed
1. Putaala J., Haapaniemi E., Kurkinen M., Salonen O., Kaste M., Tatlisumak T. Silent brain infarcts, leukoaraiosis, and long-term prognosis in young ischemic stroke patients. Neurology. 2011;76(20):1742–1749. doi: 10.1212/WNL.0b013e31821a44ad. - DOI - PubMed

LinkOut - more resources

Full Text Sources

[1] Kovács K. R., Czuriga D., Bereczki D., Bornstein N. M., Csiba L. Silent brain infarction - a review of recent observations. International Journal of Stroke. 2013;8(5):334–347. doi: 10.1111/j.1747-4949.2012.00851.x. - DOI - PubMed

[2] Kovács K. R., Czuriga D., Bereczki D., Bornstein N. M., Csiba L. Silent brain infarction - a review of recent observations. International Journal of Stroke. 2013;8(5):334–347. doi: 10.1111/j.1747-4949.2012.00851.x. - DOI - PubMed

[3] Vermeer S. E., Hollander M., Van Dijk E. J., Hofman A., Koudstaal P. J., Breteler M. M. B. Silent brain infarcts and white matter lesions increase stroke risk in the general population: The Rotterdam Scan Study. Stroke. 2003;34(5):1126–1129. doi: 10.1161/01.STR.0000068408.82115.D2. - DOI - PubMed

[4] Vermeer S. E., Hollander M., Van Dijk E. J., Hofman A., Koudstaal P. J., Breteler M. M. B. Silent brain infarcts and white matter lesions increase stroke risk in the general population: The Rotterdam Scan Study. Stroke. 2003;34(5):1126–1129. doi: 10.1161/01.STR.0000068408.82115.D2. - DOI - PubMed

[5] Vermeer S. E., Prins N. D., den Heijer T., Hofman A., Koudstaal P. J., Breteler M. M. B. Silent brain infarcts and the risk of dementia and cognitive decline. The New England Journal of Medicine. 2003;348(13):1215–1222. doi: 10.1056/nejmoa022066. - DOI - PubMed

[6] Vermeer S. E., Prins N. D., den Heijer T., Hofman A., Koudstaal P. J., Breteler M. M. B. Silent brain infarcts and the risk of dementia and cognitive decline. The New England Journal of Medicine. 2003;348(13):1215–1222. doi: 10.1056/nejmoa022066. - DOI - PubMed

[7] Debette S., Beiser A., Decarli C., et al. Association of MRI markers of vascular brain injury with incident stroke, mild cognitive impairment, dementia, and mortality: The framingham offspring study. Stroke. 2010;41(4):600–606. doi: 10.1161/STROKEAHA.109.570044. - DOI - PMC - PubMed

[8] Debette S., Beiser A., Decarli C., et al. Association of MRI markers of vascular brain injury with incident stroke, mild cognitive impairment, dementia, and mortality: The framingham offspring study. Stroke. 2010;41(4):600–606. doi: 10.1161/STROKEAHA.109.570044. - DOI - PMC - PubMed

[9] Putaala J., Haapaniemi E., Kurkinen M., Salonen O., Kaste M., Tatlisumak T. Silent brain infarcts, leukoaraiosis, and long-term prognosis in young ischemic stroke patients. Neurology. 2011;76(20):1742–1749. doi: 10.1212/WNL.0b013e31821a44ad. - DOI - PubMed

[10] Putaala J., Haapaniemi E., Kurkinen M., Salonen O., Kaste M., Tatlisumak T. Silent brain infarcts, leukoaraiosis, and long-term prognosis in young ischemic stroke patients. Neurology. 2011;76(20):1742–1749. doi: 10.1212/WNL.0b013e31821a44ad. - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Longitudinal Study on Low-Dose Aspirin versus Placebo Administration in Silent Brain Infarcts: The Silence Study

Affiliations

Longitudinal Study on Low-Dose Aspirin versus Placebo Administration in Silent Brain Infarcts: The Silence Study

Authors

Affiliations

Abstract

Similar articles

Cited by

References

LinkOut - more resources

Full Text Sources