Antiplatelet Secondary Prevention International Randomised Trial After INtracerebral HaemorrhaGe (ASPIRING)-Pilot Phase

The participant eligibility criteria specifically identify adults with history of symptomatic spontaneous ICH. Randomisation occurs if a participant and their doctor are uncertain about whether to start or avoid antiplatelet monotherapy at least 24 hours after ICH symptom onset. The intervention is a pragmatic policy of starting antiplatelet monotherapy (one antiplatelet drug available in local standard clinical practice, chosen by patient's physician pre-randomisation). The control group adopts a policy of avoiding antiplatelet therapy.

Inclusion criteria

• Patient age ≥18 years.
• Symptomatic stroke due to spontaneous (non-traumatic) ICH.
• Patient is at least 24 hours after ICH symptom onset.
• Patient and their doctor are both uncertain about whether to start or avoid antiplatelet monotherapy.
• Consent to randomisation from the patient (or personal / legal / professional representative if the patient does not have mental capacity).

Exclusion criteria

• ICH due to head injury, in the opinion of the investigator.
• ICH due to haemorrhagic transformation of an ischaemic stroke, in the opinion of the investigator.
• Patient is already taking antiplatelet therapy, or full dose anticoagulant therapy, after ICH.
• Patient is pregnant, breastfeeding, or of childbearing age and not taking contraception.
• Patient and carer unable to understand spoken or written local language.