The REstart or STop Antithrombotics Randomised Trial (RESTART) after stroke due to intracerebral haemorrhage: study...

Area of Science:

• Neurology
• Clinical Trials
• Vascular Medicine

Background:

• Adults surviving spontaneous intracerebral hemorrhage (ICH) often take antithrombotic drugs.
• The decision to restart antiplatelet therapy after ICH is complex, balancing recurrent ICH risk against potential vascular event reduction.

Purpose of the Study:

• To determine if restarting antiplatelet drugs after ICH increases recurrent ICH risk.
• To assess the net benefit of antiplatelet drugs in reducing all serious vascular events compared to avoidance.

Main Methods:

• The REstart or STop Antithrombotics Randomised Trial (RESTART) is a UK-based, randomized, open-label trial.
• 122 UK hospitals are enrolling adults surviving antithrombotic-associated ICH, randomizing them 1:1 to start or avoid antiplatelet drugs.
• Primary outcome is recurrent symptomatic ICH; secondary outcomes include other hemorrhagic and vaso-occlusive events, and functional outcomes via modified Rankin Scale.

Main Results:

• Final results of the RESTART trial are pending analysis and dissemination.
• The trial aims to recruit at least 720 participants, with a sub-study including brain MRI for 550 participants.

Conclusions:

• The RESTART trial will provide crucial data on the safety and efficacy of antiplatelet therapy post-ICH.
• Findings will inform clinical guidelines regarding antithrombotic management in stroke survivors.