Many strokes and heart attacks that happen after brain haemorrhage are caused by blood clots, so aspirin or clopidogrel might help to prevent them.
However, doctors aren’t sure whether aspirin or clopidogrel can be used for people who have had a brain haemorrhage.
The RESTART study
That’s why we did a study called the REstart or STop Antithrombotics Randomised Trial, known as “RESTART”. RESTART was a randomised study involving 537 survivors of brain haemorrhage in the UK.
- People taking part in RESTART had a brain haemorrhage and diseases that block blood flow due to clotting.
- RESTART split these people into two groups: half were encouraged to start aspirin or clopidogrel, and half were encouraged to stay off antiplatelet medicines.
- We were pleased to find that fewer people in RESTART who started aspirin or clopidogrel had another brain haemorrhage compared to people who kept off antiplatelet medicines. Aspirin and clopidogrel also seemed to cause fewer major vascular events.
- You can find out more about RESTART at www.RESTARTtrial.org.
- RESTART’s results are promising. But a bigger randomised controlled study is needed to find out if adding aspirin or clopidogrel to standard care is acceptably safe and helps a wide range of brain haemorrhage survivors, compared with standard care alone.
The ASPIRING study
This study is called ASPIRING, which stands for, “Antiplatelet Secondary Prevention International Randomised study after INtracerebral haemorrhaGe”
ASPIRING will be the largest and most reliable study of aspirin and clopidogrel after brain haemorrhage. It will involve more than four thousand people worldwide.
This study aims to produce reliable information about whether aspirin or clopidogrel help people after brain haemorrhage. The findings of ASPIRING could affect how doctors treat people with brain haemorrhage in everyday medical practice worldwide in the future. If ASPIRING shows that aspirin or clopidogrel works, this could prevent another major vascular event for thousands of brain haemorrhage survivors worldwide each year.
ASPIRING was prospectively registered on the ISRCTN registry on 15 July 2024: ISRCTN16705062.
