Influence of Antiplatelet Drugs on the Outcome of Subarachnoid Hemorrhage Differs with Age.

ABSTRACT

BACKGROUND: The aim of this study was to examine the risk factor profiles and functional outcomes of subarachnoid hemorrhage (SAH) in different age groups, focusing on the effect of antiplatelet drugs when used before stroke. METHODS: A total of 5344 patients with SAH were included in a multicenter, hospital-based registration study involving 95 Japanese institutes from 2000 to 2012. Patients' profiles and use of antithrombotic agents were retrospectively reviewed. A modified Rankin Scale score of 4 or more at discharge was defined as poor outcome. RESULTS: The frequency of antithrombotic agent use increased with age; it reached its peak (10.9%) among patients in their 80s and remained constant at 7.5% for those 90 years or older. Poorer outcomes were evident as age increased. The frequency of hypertension increased with age, whereas current smoking and heavy drinking reached its peak among patients in their 40s and 50s, respectively. The use of antiplatelet agents significantly improved outcome in patients younger than 60 years (P = .04). In contrast, in the older group (≥60 years), the use of antiplatelet agents tended to worsen the outcome; patients aged 70-79 years who had used these agents had a significantly worse outcome compared with those who had not (P = .03). CONCLUSIONS: In the present study, the influence of antiplatelet agents was different among age groups. The potential beneficial effects of antiplatelet agents must be weighed against their potential adverse effects in the context of SAH, considering the differences in age-related outcomes.