Aspirin and growth, rupture of unruptured intracranial aneurysms: A systematic review and meta-analysis.

Abstract Objectives Aspirin has been suggested as a potential therapeutic strategy to prevent the growth and rupture of unruptured intracranial aneurysms (UIAs), but there is still controversy. The aim of this systematic review and meta–analysis is to determine the association between aspirin use and growth, rupture of UIAs. Methods We performed a systematic literature search of electronic databases to identify cohort and case–control studies investigating the relationship between aspirin use and growth or rupture of UIAs. Pooled odds ratio (OR) with corresponding 95% confidence interval (CI) were calculated using a random effects model. Heterogeneity among studies was quantified using the I2 statistic, and potential publication bias was assessed using funnel plots. Sensitivity analysis was performed to verify the robustness of the intention–to–treat results. Subgroup analysis was conducted according to the frequency of aspirin use. Results We identified 8 studies comprising 10,518 participants. The risk of bias was low to moderate. The pooled estimate showed that aspirin use was associated with a lower likelihood of growth of UIAs (OR = 0.25, 95% CI = 0.11–0.55; p = 0.0005) without statistical heterogeneity (p for Cochran Q statistic = 0.62, I2 = 0%). Likewise, aspirin intake also significant decreased 58% risk of intracranial aneurysms rupture (OR = 0.42, 95% CI = 0.29–0.60; p  Conclusions The results of this systematic review and meta–analysis indicates a beneficial effect of aspirin on growth and rupture of UIAs.