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Aneurysmal Subarachnoid Hemorrhage (aSAH)Phase 4aSAH-ASANCT07642427

Early Prophylactic Aspirin for Aneurysmal Subarachnoid Hemorrhage

A Phase 4 study testing Aspirin in people with Aneurysmal Subarachnoid Hemorrhage (aSAH) and Delayed Cerebral Ischemia, run by Ganzhou City People's Hospital at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This study is a multicenter, prospective, double-blind, randomized controlled trial designed to evaluate whether early prophylactic use of aspirin improves functional outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Aspirin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
388 participants
Where
1 siteChina
Study dates
1 Jun 2026to Aug 2029
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years and ≤ 80 years.
  • Spontaneous subarachnoid hemorrhage (SAH) confirmed by non-contrast head CT.
  • Diagnosis of ruptured intracranial aneurysm confirmed, and successfully treated by either surgical clipping or endovascular coiling within 48 hours of ictus.
  • Hunt-Hess grade ≤ 4 or WFNS grade ≤ 4 (assessed within 48 hours of SAH onset).
  • Fisher grade 2-4 or modified Fisher grade 1-4.
  • No significant focal neurological deficit after aneurysm intervention, defined as NIHSS scores ≤ 1 in the following items: 5a (left arm motor), 5b (right arm motor), 6a (left leg motor), 6b (right leg motor), and 9 (language).
  • Pre-morbid modified Rankin Scale (mRS) score ≤ 1 prior to SAH onset.

Who cannot join

  • Hunt-Hess grade 5 or WFNS grade 5 (assessed within 48 hours of SAH onset).
  • Patients requiring any intracranial stent or non-embolic intrasaccular device during aneurysm embolization, with post-procedural need for antiplatelet therapy.
  • Angiogram-negative SAH.
  • Note: Prior history of ruptured intracranial aneurysm or re-rupture of previously treated aneurysm is not excluded.
  • Moderate-to-severe vasospasm demonstrated on pre-operative or intra-operative CTA/DSA in the emergency setting.
  • SAH caused by non-saccular aneurysms, including mycotic, blood-blister, fusiform, or dissecting aneurysms, or cases without basal cistern subarachnoid hemorrhage.
Show all 28Show fewer
  • Significant pre-existing intracranial pathology at the time of enrollment, including but not limited to: traumatic brain injury, moyamoya disease, high suspicion or documented CNS vasculitis, severe fibromuscular dysplasia, arteriovenous malformation, arteriovenous fistula, significant cervical or intracranial atherosclerotic stenosis (≥70%), or malignant brain tumor.
  • Medical conditions requiring chronic use of antiplatelet agents (aspirin, clopidogrel, or ticagrelor), such as transient ischemic attack, myocardial infarction, atrial fibrillation, prosthetic heart valve, arteriovenous fistula, unstable angina, or other conditions requiring thromboprophylaxis.
  • Thrombocytopenia (platelet count <20,000/μL, excluding aggregation artifacts), active disseminated intravascular coagulation (DIC) at enrollment, or documented history of coagulopathy or bleeding diathesis.
  • History of gastrointestinal bleeding or major systemic hemorrhage within 30 days, hemoglobin <8 g/dL at admission, INR ≥1.5, or severe hepatic impairment defined as AST, ALT, alkaline phosphatase (AP), or GGT >2 times the upper limit of normal.
  • Creatinine clearance <30 mL/min.
  • Severe comorbidities that may confound study outcomes, including but not limited to: multiple sclerosis, dementia, major depression, immunosuppressed state or during intensive immunosuppressive therapy, cancer with expected survival <1 year, multi-organ failure, or any other condition potentially causing cognitive impairment.
  • Contraindications to aspirin therapy, including:
  • Hypersensitivity to aspirin, other salicylates, or any excipients in the formulation;
  • History of asthma induced by salicylates or NSAIDs;
  • Active peptic ulcer disease;
  • Bleeding diathesis;
  • Hepatic or renal failure;
  • Uncontrolled severe heart failure;
  • Concomitant use with methotrexate at doses ≥15 mg/week.
  • Pregnancy or positive HCG test.
  • Incomplete repair of the responsible aneurysm as judged by the treating physician, with high risk of early re-bleeding.
  • History of head trauma within 3 months prior to SAH onset.
  • Recent cerebral disease within 3 months prior to SAH onset, such as tumor, stroke, epilepsy, vasculitis, AVM, or hydrocephalus.
  • History of psychiatric illness or seizure disorder.
  • Breastfeeding women.
  • Expected survival <1 year prior to SAH onset.
  • Participation in another randomized clinical trial that may confound the evaluation of this study.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Weilong Huang, MD. PhD. contact

+8618807971121

doctorhwl@163.com

Zhenyu zhang, MD. PhD. contact

+8615297777969

623071778@qq.com

China1 site
  • Ganzhou People's Hospital

    Ganzhou, Jiangxi, 341000

    Qiuhuang Jiang, MD, PhD, +8613607979100, jiangqh1968@126.com

    Xinyun Ye, MD, PhD, +8615979789987, yexinyun1270@163.com

Other trials in China

About this study

Official title: Study on the Efficacy and Safety of Early Prophylactic Use of Aspirin in Improving Prognosis of Patients With Aneurysmal Subarachnoid Hemorrhage: A Multicenter, Prospective, Double-Blind, Randomized Controlled Trial

This study is a multicenter, prospective, double-blind, randomized controlled trial designed to evaluate whether early prophylactic use of aspirin improves functional outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). Patients with aSAH who have undergone successful aneurysm securing will be randomly assigned to receive either aspirin plus standard care or a placebo plus standard care. The study drug will be started within 48 hours of undergone successful aneurysm securing and continued for not less than 10 days and not more than 14 consecutive days. The main goal is to compare the rate of favorable functional outcomes at 3 months between the two groups. Secondary goals include evaluating the incidence of delayed cerebral ischemia, cerebral infarction, mortality, and safety outcomes such as major bleeding events.

Read the detailed description

Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening neurological emergency associated with high rates of morbidity and mortality. Delayed cerebral ischemia (DCI) and subsequent cerebral infarction are major contributors to poor functional outcomes in survivors. Antiplatelet agents such as aspirin have been hypothesized to reduce the risk of microthrombosis and DCI, but evidence for their early prophylactic use in aSAH remains limited and controversial. This trial aims to investigate the efficacy and safety of early aspirin administration in improving long-term functional outcomes in aSAH patients. Eligible patients will be randomized into two groups: the intervention group will receive 100 mg of oral aspirin daily for not less than 10 days and not more than 14 consecutive days, while the control group will receive an identical placebo. All patients in both groups will receive standardized aSAH management according to current clinical guidelines, including nimodipine, blood pressure control, and supportive care. The primary endpoint is the functional outcome measured by the modified Rankin Scale (mRS) at 3 months. Secondary endpoints include incidence of clinical DCI at discharge, percentage of imaging DCI detected on CT/MRI at discharge, all-cause mortality at 3 months, and safety outcomes including major bleeding events.

Being tested
Aspirin, Placebo
Keywords
Aneurysmal subarachnoid hemorrhage, Aspirin, Delayed cerebral ischemia, Antiplatelet therapy, Functional outcome, Randomized controlled trial
Medical subject headings
Subarachnoid Hemorrhage

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AspirinDrug

    Aspirin 100 mg (1 tablet) administered orally, via nasogastric tube, or rectally within 48 hours after aneurysm embolization or surgical clipping, once daily, for a minimum of 10 consecutive days and a maximum of 14 consecutive days.

  • PlaceboDrug

    Placebo 1 tablet (identical in appearance to aspirin 100 mg) administered orally, via nasogastric tube, or rectally within 48 hours after aneurysm embolization or surgical clipping, once daily, for a minimum of 10 consecutive days and a maximum of 14 consecutive days.

Study groups in NCT07642427
Study groupRoleWhat they receive
Aspirin GroupExperimentalPatients receive 100 mg aspirin once daily, initiated within 48 hours of undergone successful aneurysm securing and continued for not less than 10 consecutive days and not more than 14 consecutive days, plus standard care.
Receives: Drug: Aspirin
Placebo Control GroupPlacebo comparatorPatients receive identical-appearing placebo capsules once daily, initiated within 48 hours of undergone successful aneurysm securing and continued for not less than 10 consecutive days and not more than 14 consecutive days, plus standard care.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of patients with mRS 0-2 at 90 days after randomization

    The proportion of patients with modified Rankin Scale (mRS) scores ranging from 0 to 2 at 90 days after randomization.

    Measured: 90 days after randomization

Secondary outcomes (15)
  1. Extended Glasgow Outcome Scale (eGOS) at 90 days

    Functional prognosis assessed by Extended Glasgow Outcome Scale (eGOS) at 90 days after randomization.

    Measured: 90 days after randomization

  2. Ordinal shift analysis of mRS at 90 days (mRS 5 and 6 combined)

    Ordinal shift analysis of modified Rankin Scale scores at 90 days after randomization, with mRS grade 5 and 6 merged into one category.

    Measured: 90 days after randomization

  3. Proportion of patients with mRS 0-3 at 90 days

    Proportion of patients with modified Rankin Scale scores of 0 to 3 at 90 days after randomization.

    Measured: 90 days after randomization

  4. Mini-Mental State Examination (MMSE) score at 90 days

    Cognitive function assessed via Mini-Mental State Examination (MMSE) scale.

    Measured: 90 days after randomization

  5. Extended Glasgow Outcome Scale (eGOS) at 1 year

    Functional outcome assessed by Extended Glasgow Outcome Scale at 1 year after randomization.

    Measured: 1 year after randomization.

  6. Ordinal shift analysis of mRS at 1 year (mRS 5 and 6 combined)

    Ordinal shift analysis of modified Rankin Scale scores at 1 year after randomization, combining mRS 5 and mRS 6 into a single category.

    Measured: 1 year after randomization

  7. Proportion of mRS 0-2 at 1 year

    Proportion of patients with modified Rankin Scale scores of 0 to 2 at 1 year after randomization.

    Measured: 1 year after randomization.

  8. Proportion of patients with mRS 0-3 at 1 year

    Percentage of subjects achieving modified Rankin Scale scores from 0 to 3 at one year after randomization.

    Measured: 1 year after randomization.

  9. Mini-Mental State Examination (MMSE) score at 1 year

    Cognitive function evaluated by Mini-Mental State Examination (MMSE) scale.

    Measured: 1 year after randomization

  10. Change in NIHSS score from baseline at discharge

    Changes in National Institutes of Health Stroke Scale (NIHSS) scores at discharge compared with baseline levels.

    Measured: 30 days/discharge, which ever is earlier

  11. Incidence of clinical delayed cerebral ischemia at discharge

    Incidence rate of clinical delayed cerebral ischemia (DCI) observed at hospital discharge.

    Measured: 30 days/discharge, which ever is earlier

  12. Percentage of radiological DCI on CT/MRI at discharge

    Proportion of patients with radiological delayed cerebral ischemia confirmed by cranial CT or MRI at hospital discharge.

    Measured: 30 days/discharge, which ever is earlier

  13. Lesion volume of radiological DCI on CT/MRI at discharge

    Volume of lesions consistent with radiological delayed cerebral ischemia detected by cranial CT or MRI at hospital discharge.

    Measured: 30 days/discharge, which ever is earlier

  14. Incidence of invasive interventions

    Incidence of invasive interventions including DSA and angioplasty performed during hospitalization.

    Measured: 30 days/discharge, which ever is earlier

  15. Rate of cerebrospinal fluid shunt surgery within 3 months

    Proportion of patients receiving cerebrospinal fluid shunt surgery within 3 months after randomization.

    Measured: Within 3 months after randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jun 2026
  2. Study start1 Jun 2026 (estimated)
  3. Primary completionMay 2029 (estimated)
  4. Study completionAug 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a randomized, double-blind, parallel-group study. Eligible patients with aSAH will be assigned to either the aspirin intervention group or the placebo control group in a 1:1 ratio.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
388 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07642427
Sponsor's protocol ID
GZPH-PJB2025-420-01
Acronym
aSAH-ASA
Status last verified
Jun 2026
First submitted
28 May 2026
Last updated
11 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data (IPD) cannot be shared due to patient privacy requirements, institutional policies, and legal and regulatory restrictions.

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Aspirin in people with Aneurysmal Subarachnoid Hemorrhage (aSAH) and Delayed Cerebral Ischemia, run by Ganzhou City People's Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 28 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 11 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Weilong Huang, MD. PhD. (+8618807971121, doctorhwl@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of patients with mRS 0-2 at 90 days after randomization (time frame: 90 days after randomization). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jun 2026; AzTrials last refreshed its copy on 26 Oct 2026.

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