Background: - Stroke remains a leading global public health concern, affecting both developed and developing nations. Approximately 15 million individuals experience a stroke annually, with 6 million resulting in death and 5 million leading to long-term disability. Preventive strategies encompass both pharmacological and non-pharmacological approaches, among which aspirin has been widely studied. This systematic review and meta-analysis aim to evaluate the effectiveness of aspirin in preventing stroke among patients at high risk of vascular disease.

Methods: - A comprehensive literature search was conducted across Cochrane Library, CINAHL Plus with Full Text, Web of Science, and ScienceDirect. Eligible studies were randomized controlled trials (RCTs) investigating the use of aspirin for stroke prevention in high-risk vascular patients. Multiple reviewers independently conducted data extraction, risk of bias assessment, and quality appraisal, guided by the Centre for Reviews and Dissemination (CRD) and the Cochrane Collaboration standards.

Results: - Seven RCTs met the inclusion criteria, involving a total of 42,918 participants. Although methodological and outcome measurement variations were noted across studies, fixed-effects meta-analysis with a 95% confidence interval revealed a statistically significant benefit of aspirin in stroke prevention. The findings consistently favoured aspirin over other or no interventions.

Discussion: - While the results support the effectiveness of aspirin in reducing stroke incidence in high-risk vascular patients, variations in study design and outcomes highlight the need for caution in interpretation. This review did not address the safety profile or cost-effectiveness of aspirin, which are critical components of clinical decision-making.

Conclusion: - Aspirin appears to be an effective intervention for stroke prevention in individuals at high risk of vascular disease. Future research should explore its safety, long-term outcomes, and economic implications to guide more comprehensive clinical guidelines.

Aspirin, Stroke Prevention, Vascular Disease, Systematic Review, Randomized Controlled Trials, Antiplatelet Therapy

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