Antiplatelet Drug Therapy After Intracerebral Hemorrhage?

Patients who are taking antithrombotic agents occasionally develop intracerebral hemorrhage (ICH). When this happens, the clinician faces a conundrum: Should the antithrombotic agent eventually be restarted if the patient continues to have a valid indication for it? To address this question, researchers in the U.K. performed a randomized trial that involved 537 adults who had spontaneous ICH while taking antiplatelet or anticoagulant drugs for preventing occlusive vascular disease; about a quarter of patients also had atrial fibrillation. After an interval during which antithrombotic therapy was withheld (averaging about 2 to 3 months), patients either started antiplatelet therapy (i.e., aspirin, clopidogrel, or dipyridamole) or were instru…