Evidence map›Paper›PMID 42100829›Full record

Trial reportStroke2026

Polygenic Risk Identifies Older Adults Who May Benefit From Aspirin for the Primary Prevention of Ischemic Stroke.

Chenglong Yu, Sultana Monira Hussain, Peter D Fransquet, Cammie Tran, Andrew M Tonkin, Mark R Nelson, Christopher M Reid, Johannes T Neumann, Jeff D Williamson, Charles B Eaton and 6 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01038583 (Aspirin in Reducing Events in the Elderly), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

NCT01038583 unknown statusnot on this map

Aspirin in Reducing Events in the Elderly

TypeobservationalSponsorHennepin Healthcare Research InstituteRan2010 to 2024Enrolled19,114ConditionsFunctional Disability, Dementia, Heart Disease, StrokeArms100 mg enteric-coated aspirin, Placebo
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Chenglong YuSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0002-0546-2779
Sultana Monira HussainSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0001-7894-2485
Peter D FransquetSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0002-3515-0557
Cammie TranSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0003-3997-6118
Andrew M TonkinSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0001-5291-0610
Mark R NelsonSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0001-9941-7161
Christopher M ReidSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0001-9173-3944
Johannes T NeumannSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0002-9478-2757
Jeff D WilliamsonDepartment of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC (J.D.W.).
Charles B EatonDepartment of Family Medicine and Department of Epidemiology, Brown University, Providence, RI (C.B.E.).ORCID 0000-0002-7723-9461
Peter HandDepartment of Neuroscience, School of Translational Medicine (P.H., A.B., G.C.C.), Monash University, Melbourne, Victoria, Australia.
Geoffrey A DonnanMelbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (G.A.D.).ORCID 0000-0001-6324-3403
Amy BrodtmannDepartment of Neuroscience, School of Translational Medicine (P.H., A.B., G.C.C.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0001-9466-2862
Geoffrey C CloudDepartment of Neuroscience, School of Translational Medicine (P.H., A.B., G.C.C.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0002-8365-6907
John J McNeilSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0002-1049-5129
Paul LacazeSchool of Public Health and Preventive Medicine (C.Y., S.M.H., P.D.F., C.T., A.M.T., M.R.N., C.M.R., J.T.N., J.J.M., P.L.), Monash University, Melbourne, Victoria, Australia.ORCID 0000-0002-0902-6798

Funding

ASPirin in Reducing Events in the ElderlyU01AG029824 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI MCNEIL, JOHN JAMES, MURRAY, ANNE M · 2009 to 2018
$64.6M
Main Administrative CoreU19AG062682 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI CHAN, ANDREW T, MCNEIL, JOHN JAMES · 2019 to 2023
$42.9M
NIA NIH HHS U01 AG029824NIA NIH HHS U19 AG062682
6 · The paper itself

Abstract

backgroundLow-dose aspirin is no longer recommended for routine primary prevention in older adults due to bleeding risks outweighing vascular benefits. We hypothesized that an integrative polygenic score (iPGS) could identify a subgroup of older individuals who derive net benefit from aspirin for the primary prevention of ischemic stroke.

methodsWe performed post hoc analysis of the ASPREE randomized, placebo-controlled trial (Aspirin in Reducing Events in the Elderly) of daily 100-mg aspirin, in 12 031 genotyped participants of European ancestry aged >70 years without prior cardiovascular disease. The iPGS was derived from >1.2 million variants and evaluated both continuously and by quintiles. Cox models assessed associations between polygenic risk, ischemic stroke, and major bleeding events, and tested the interaction between the iPGS and treatment allocation, with adjustment for baseline lifestyle and clinical covariates.

resultsThe mean age of participants was 75.1 years, and 54.9% were women. Over a median of 4.6 years, 187 ischemic strokes and 373 major bleeds occurred, including 101 intracranial bleeds (46 hemorrhagic strokes). Each 1-SD increase in the iPGS was associated with higher incident ischemic stroke risk (hazard ratio, 1.39 [95% CI, 1.20-1.62]). An interaction between the continuous iPGS and aspirin allocation was observed for ischemic stroke (

conclusionsAmong older adults, high polygenic risk identifies individuals who may experience substantial stroke reduction with aspirin, with no excess bleeding. These findings raise the possibility that genomic risk stratification may enable targeted aspirin use for the primary prevention of ischemic stroke. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01038583.

Indexed as

AspirinBrain IschemiaIschemic StrokePlatelet Aggregation InhibitorsPrimary PreventionAgedAged, 80 and overFemaleGenetic Risk ScoreHumansMaleRisk FactorsAspirinPlatelet Aggregation Inhibitorsaspiringenotypeischemic strokepolygenic scorerandomized controlled trial

Identifiers

PMID42100829
PMCPMC13575689

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Registered trials

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.