ASPECT

Looking at whether aspirin can help prevent strokes in patients with pneumonia

• Participants aged ≥ 50 years
• Admitted to hospital with pneumonia, or decision to admit
• Symptoms and signs of acute lower respiratory tract infection
• Radiographic changes in keeping with infection on chest radiograph, CT scan, or lung ultrasound scan

• Already taking regular prescribed anti-platelet medication, including aspirin, clopidogrel, cangrelor, selexipag, cilostazol, dipyridamole, prasugrel, ticagrelor, abciximab, eptifibatide, tirofiban, epoprostenol, or iloprost
• Known allergy, previous important adverse reaction, or contraindication to aspirin
• At high risk of excessive bleeding (e.g. large trauma or haemorrhage, urgent need for major surgery, or uncorrectable coagulopathy) in the opinion of the treating physician
• Hospital-acquired pneumonia, defined as related to an inpatient hospital stay within the last 10 days, or acquired at least 48 hours after current admission
• Discharged without a 'Decision to Admit' to hospital by urgent care / emergency department
• Unlikely to tolerate or adhere to medication regimen
• Prisoners
• Known to be pregnant
• Life expectancy less than 3 months due to pre-existing condition (e.g. terminal malignancy)
• Presentation more likely due to acute COVID-19 pneumonitis in the opinion of the treating physician — i.e. newly positive PCR or similar antigen test for COVID-19
• Enrolment onto another study where the combined burden on the participant would be too high, or where dual enrolment would compromise one or both studies' objectives