In patients with pros- thetic heart valves, early resumption of anticoagulation may be necessary because of the high risk of embolism. Although there are conflicting reports regarding the risk of ICH recur- rence with antiplatelet use, particularly in patients with lobar or percutaneous left atrial appendage closure303 might be safer alternatives to warfarin in some patients with atrial fibrillation. Antiplatelet agents do not appear to dramatically increase the risk of and therefore appear to be gener- ally safe for use after ICH, including ICH caused by CAA. Although dabigatran, rivaroxaban, and apixaban are reported to convey a lower risk of ICH than warfarin in atrial fibrilla- their usefulness as alternatives to warfarin after ICH remains to be determined. Meta-analyses suggest that aspirin use is associated with modest increases in ICH incidence305 but the absolute ICH risk in unselected populations appears to be small relative to the absolute numbers of MIs and ischemic A small observational study found that antiplatelet use was common after ICH and did not appear to be associated with an increase in the risk of ICH recurrence in 127 survivors of lobar hemorrhage (HR, 0.8; 95% CI, 0.3 2.3; P=0.73) and 80 survivors of deep hemorrhage (HR, 1.2; 95% There are conflicting reports regarding the use of statins in patients with ICH.308 312 In the Stroke Prevention With Aggressive Reduction in Cholesterol Levels (SPARCL) study, the benefit of high-dose atorvastatin in reducing recurrent ischemic stroke was offset in part by an increased risk of ICH. 