Non-steroidal anti-inflammatory drug use and functional outcome from ischemic cerebral events among women

• This cohort study examined the association between NSAIDs and stroke outcomes.
• The study enrolled women without a history of cardiovascular disease at baseline.
• Women reported NSAID use during each year of the study.
• Outcomes were TIA or ischemic stroke with mild, moderate, or severe outcome.
• NSAID use may be associated with increased risk of stroke with mild outcome.

BackgroundUse of some non-steroidal anti-inflammatory drugs (NSAIDs) has been linked to an increased risk of stroke. However, information on the impact of NSAID use on functional outcomes from stroke is limited.MethodsUsing women enrolled in the Women's Healthy Study who were free of a history of stroke or TIA at baseline, a prospective cohort study was performed to examine the impact of NSAID use on functional outcomes from stroke. Women were classified as NSAID non-user (< 11 days of use in the past month), user (≥ 11 days of use in the past month), and missing (did not answer the question about NSAID use) during each year of the study. Possible functional outcomes were TIA or ischemic stroke with modified Rankin scale (mRS) score of 0 to 1, 2 to 3, or 4 to 6.ResultsAfter 15.7 mean years of follow-up, 702 TIAs, 292 ischemic strokes with mRS 0–1, 233 ischemic strokes with mRS 2–3 and 98 ischemic strokes with mRS 4–6 occurred. Compared to women who were NSAID non-users, women who were NSAID users had multivariable-adjusted (95% CI) of 1.00 (0.77, 1.29) for TIA, 1.48 (1.04, 2.10) for mRS 0–1, 0.83 (0.52, 1.33) for mRS 2–3, and 1.33 (0.68, 2.59) for mRS 4–6.ConclusionResults from this large cohort study suggest than NSAID use may be associated with an increased risk of ischemic stroke with mild functional outcome.