Evidence map›Paper›PMID 34369077›Full record

ArticleCNS neuroscience & therapeutics2021

Association between aspirin-induced hemoglobin decline and outcome after acute ischemic stroke in G6PD-deficient patients.

Yicong Chen, Jianle Li, Zilin Ou, Yusheng Zhang, Zhijian Liang, Weisheng Deng, Weixian Huang, Fubing Ouyang, Jian Yu, Shihui Xing and 1 more

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in CNS neuroscience & therapeutics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Aspirin in patients with glucose-6-phosphate dehydrogenase deficiency: a true clinical issue?European heart journal. Cardiovascular pharmacotherapy · 2025
    Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Yicong ChenDepartment of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.ORCID 0000-0002-3907-7991
Jianle LiDepartment of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.
Zilin OuDepartment of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.
Yusheng ZhangDepartment of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Zhijian LiangDepartment of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Weisheng DengDepartment of Neurology, Meizhou People's Hospital, Meizhou, China.
Weixian HuangDepartment of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.
Fubing OuyangDepartment of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.
Jian YuDepartment of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.
Shihui XingDepartment of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.
Jinsheng ZengDepartment of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.
Sun Yat-sen University · CNFirst Affiliated Hospital of Jinan University · CNGuangxi Medical University · CNMeizhou City People's Hospital · CN

Funding

China Postdoctoral Science Foundation 2018M643333grants from the Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases 2017B030314103Sun Yat-sen University Clinical Research 5010 Program 2018001Sun Yat-sen University Young Teachers Training Project 20ykpy56the Basic and Applied Basic Research Foundation Natural Science Foundation of Guangdong Province 2021A1515010600the Basic and Applied Basic Research Foundation Natural Science Foundation of Guangdong Province 2021A1515012216the National Key R&D Program of China 2017YFC1307500the Natural Science Foundation of China 81571107the Natural Science Foundation of China 81771137the Natural Science Foundation of China 81901077the Natural Science Foundation of China 81971103the Natural Science Foundation of China 81971118the Scientific and Technical Project of Guangdong Province 2017A030303011the Southern China International Cooperation Base for Early Intervention and Functional Rehabilitation of Neurological Diseases 2015B050501003
6 · The paper itself

Abstract

aimsThe risk of hemoglobin decline induced by low-dose aspirin in glucose-6-phosphate dehydrogenase (G6PD) deficiency remains unknown, and its influence on stroke outcome remains to be investigated. This study aimed to evaluate the effect of G6PD deficiency on hemoglobin level during aspirin treatment and its association with outcome after acute ischemic stroke.

methodsIn total, 279 patients (40 G6PD-deficient and 239 G6PD-normal) with acute ischemic stroke treated with aspirin 100 mg/day from a cohort study were examined. The primary safety endpoint was a hemoglobin decline ≥25 g/L or 25% from baseline within 14 days after aspirin treatment. Poor outcomes were defined as a modified Rankin Scale score ≥2 at 3 months. The χ

resultsThe G6PD-deficient group had lower baseline hemoglobin and tended to develop comorbid pulmonary infection more frequently (p < 0.05). The proportion of patients with hemoglobin decline ≥25 g/L or 25% from baseline (15.0% vs. 3.3%; p = 0.006) and anemia (30.0% vs. 14.6%; p = 0.016) after aspirin treatment was higher in the G6PD-deficient group, which was accompanied by a more significant bilirubin increase. The rate of poor functional outcomes at 3 months after acute ischemic stroke was higher in the G6PD-deficient group (Risk ratio = 1.31 [95% confidence interval (CI) = 1.10-1.56]; p = 0.017). Confounder-adjusted analysis showed that lower hemoglobin levels (odds ratio = 0.98 [95% CI = 0.96-0.99]; adjusted p = 0.009) increased the risk of poor functional outcomes.

conclusionHemoglobin decrease with bilirubin increase after aspirin treatment in patients with G6PD deficiency suggests hemolysis, which may influence stroke prognosis. The risk of hemoglobin decline should be carefully monitored in G6PD-deficient patients with ischemic stroke taking aspirin.

Indexed as

AgedAnemiaAnti-Inflammatory Agents, Non-SteroidalAspirinCohort StudiesEndpoint DeterminationFemaleGlucosephosphate DehydrogenaseGlucosephosphate Dehydrogenase DeficiencyHemoglobinsHumansIschemic StrokeLung DiseasesMaleMiddle AgedProspective StudiesAnti-Inflammatory Agents, Non-SteroidalAspirinG6PD protein, humanGlucosephosphate DehydrogenaseHemoglobinsaspirinG6PD deficiencyhemoglobinoutcomestroke

Identifiers

PMID34369077
PMCPMC8446213
OpenAlexW3188200339

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.