Aspirin green light for brain bleed stroke patients

Edinburgh university researchers find anti-clotting medicines group does not increase risk of brain haemorrhage recurrences

Wednesday 22nd May 2019

People who have suffered stroke caused by brain haemorrhage can take common medicines such as aspirin without increasing the risk of another stroke, a major clinical trial has found.

Researchers led by the University of Edinburgh say the findings offer reassurance for people who regularly take antiplatelet medicines to stop their blood clotting and reduce the risk of heart attack or a different type of stroke.

Professor Metin Avkiran of the British Heart Foundation, which funded the study, said: “Around a third of people who suffer a brain haemorrhage, also known as haemorrhagic stroke, do so when they are taking an antiplatelet medicine such as aspirin to reduce the risk of a heart attack or an ischaemic stroke.

“We now have a strong indication they can carry on taking these potentially life-saving medicines after the brain haemorrhage without increasing the risk of another one, which is crucial new information for both patients and doctors.”

Doctors were concerned the medicines, which also include clopidogrel, could make brain haemorrhages more likely.

But by tracking the outcomes of more than 500 people across the UK, researchers found the medicines did not increase the chance of another haemorrhage.

Patients were randomly assigned to either start taking antiplatelet treatment or avoid it for up to five years.

Those taking the medicines had fewer recurrences of brain haemorrhage compared to the group that didn’t, the study found.

This could mean the treatments actually reduce the risk of further brain bleeds – but researchers say further studies are needed to confirm this.

RESTART, which was funded by the British Heart Foundation, was published in the Lancet and the Lancet Neurology.

Professor Avkiran continued: “Although some developments have been made, the options at our disposal for treating and preventing strokes are still far too limited. Around 36,000 people die each year in the UK after having a stroke, most commonly an ischaemic stroke. Every advance from important research such as this takes us a step closer to better stroke prevention and management.”

Professor Rustam Salman of the University of Edinburgh’s centre for clinical brain sciences added: “The results of the RESTART trial are reassuring for survivors of brain haemorrhage who need to take antiplatelet medicines to prevent heart attacks and strokes. I am keen to investigate the possibility that these medicines might halve the risk of brain haemorrhage happening again.”