Research Highlights:
- Based on an analysis of a decade of hospital stroke registry data, people who had brain bleeds were more likely to die in the hospital if they were taking multiple antiplatelet medications, or medications stronger than aspirin, before the bleed.
- People who were taking only aspirin before the brain bleed had the same risk of death as those not taking any antiplatelet medications.
- The results open the door to research on how to improve care for people hospitalized with a brain bleed who have been taking antiplatelet medications.
- Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association/American Stroke Association's scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as full manuscripts in a peer-reviewed scientific journal.
Embargoed until 4 a.m. CT/5 a.m. ET, Thursday, Jan. 29, 2026
DALLAS, Jan. 29, 2026 — Analysis of hospital registry data found that people who were hospitalized due to bleeding in the brain and who had taken multiple antiplatelet medications, or medications stronger than aspirin, were more likely to die before leaving the hospital compared to those not taking any antiplatelet medication, according to a preliminary study to be presented at the American Stroke Association's International Stroke Conference 2026 . The meeting is in New Orleans, Feb. 4-6, 2026, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.
Antiplatelet medications are prescribed to stop blood clot formation by making blood platelets less sticky. These medications are often prescribed in the treatment and prevention of heart attacks and ischemic strokes . Aspirin is a commonly prescribed, mild anti-clotting medication that can help prevent ischemic strokes, which are caused by blood clots. Sometimes, a patient will also be prescribed one or more stronger antiplatelet medications (such as clopidogrel, prasugrel and ticagrelor) in addition to aspirin after a heart attack or ischemic stroke.
"Previous research assessing the relationship between antiplatelet therapy and patient outcomes after a brain bleed has grouped all the medications together. We conducted this study to find out if different antiplatelet medications or combinations affect overall death and recovery in people with a brain bleed," said lead study author Santosh Murthy, M.D., M.P.H., an associate professor of neurology and neuroscience at Weill Cornell Medicine in New York City.
Researchers analyzed a decade of data for more than 400,000 adults in the U.S. hospitalized for a brain bleed (intracranial hemorrhage) without a traumatic brain injury or any other type of stroke who received care at a hospital participating in the American Heart Association's Get With The Guidelines-Stroke Registry . Patients who were on anticoagulant medication were excluded. The short-term outcome was considered unfavorable if a patient died or was sent to hospice care vs. favorable if a patient was discharged home or to another care setting.
Among 426,481 people hospitalized with intracranial hemorrhage, 109,512 were taking only one antiplatelet, 17,009 were taking two antiplatelet medications, while 300,558 did not receive any antiplatelet treatment before the brain bleed.
The researchers found that when compared to patients with no antiplatelet therapy before the brain bleed:
- Patients taking aspirin alone did not have an increased risk of dying in the hospital, and aspirin was associated with lower odds of an unfavorable outcome.
- Patients taking a stronger antiplatelet medication, either alone or in combination with aspirin, had an increased risk of death in the hospital.
- There was a trend towards patients taking stronger antiplatelet medications or dual therapy having an increased risk of an unfavorable outcome.
American Stroke Association volunteer expert, Jonathan Rosand, M.D., M.Sc., FAHA, said, "Using dual antiplatelet therapy and new generation antiplatelet drugs has improved the lives of many people with coronary artery disease. However, there are risks involved. Patients on these medications have a slightly higher chance of having a bleeding stroke. This new study shows that if a stroke occurs while on these treatments, it is more likely to be fatal. If you're on these medications, check with your health care professional to ensure they are still right for you. If your health care professional advises you to continue, it likely means they are helping you more than they are harming you." Rosand is also a professor of neurology at Harvard, holds the JP Kistler Endowed Chair in Neurology at Massachusetts General Hospital and is founder of the Global Brain Care Coalition. Rosand was not involved in this study.
"These results do not imply that people should be reluctant to take antiplatelet medications if recommended," Murthy said. "The findings of our study show that if patients have a brain bleed, the type of antiplatelet medication they were taking before the bleed may affect their risk of death or other severe outcomes. It is important to note that we did not analyze the risk of having a brain bleed from different antiplatelet medications. And with more research, these results may help inform how antiplatelet-associated intracranial hemorrhage is managed in the hospital. Currently, antiplatelet medications are discontinued immediately after a bleed. Another option may be giving patients transfusions of donor platelets to lower the bleeding risk."
Current guidelines do not recommend platelet transfusions for patients with bleeding in the brain if they are taking one or more antiplatelet medications, unless they need immediate surgery. Future studies should examine whether platelet transfusions affect the outcomes differently in patients after brain bleeds who were taking single or dual antiplatelet therapies.
The current study is limited because it did not consider specific characteristics of the brain bleed, such as the amount of blood or where in the brain tissue the bleed was located and if it involved the fluid-filled cavities in the brain. These measures could help gauge the severity of the brain bleed and how each might influence the patient's outcomes.
Intracranial hemorrhage accounts for about 10% of all strokes in the U.S., according to the American Heart Association's 2026 Heart Disease and Stroke Statistics .
Study details, background and design:
- Data for 426,481 adults who were hospitalized due to an intracranial hemorrhage (average age of 67 years; 53% were men).
- All participants were treated between 2011-2021 at a hospital in the U.S. participating in the American Heart Association's Get With the Guidelines-Stroke Registry.
- The Get With The Guidelines registry is the largest program in the U.S. that collects data from hundreds of hospitals nationwide to help improve care for heart disease and stroke. These hospitals treat patients who reflect the diverse U.S. population.
- Researchers used multiple logistic regression, a statistical method that can account for the influence of multiple factors on a yes-or-no result (in this case, a favorable or unfavorable hospital outcome), to examine the relationship between various types and numbers of antiplatelet medications.
- The results were adjusted for: demographic factors; other vascular conditions (such as diabetes, high blood pressure, high cholesterol and a history of heart disease) that might influence both the use of antiplatelet medications and the risk of a poor outcome after a brain bleed; severity of the brain bleed on the NIHSS Stroke Scale; use of a ventricular drain; and hospital characteristics (including whether it was located in a city, if it was a teaching hospital and how many strokes treated at the hospital each year).
Co-authors, disclosures and funding sources are listed in the abstract.
Statements and conclusions of studies that are presented at the American Heart Association/American Stroke Association's scientific meetings are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association's scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.
