Apixaban to Prevent Recurrence After Cryptogenic Stroke in Patients With Atrial Cardiopathy: The ARCADIA Randomized Clinical Trial
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View abstract on PubMed
Summary
This summary is machine-generated.In patients with cryptogenic stroke and atrial cardiopathy, apixaban did not reduce recurrent stroke risk compared to aspirin. This study found no significant difference in stroke prevention between the two treatments.
Area Of Science
- Cardiology
- Neurology
- Clinical Trials
Background
- Atrial cardiopathy is linked to stroke, even without diagnosed atrial fibrillation.
- The efficacy of anticoagulation for stroke prevention in this specific patient group is unclear.
Purpose Of The Study
- To compare anticoagulation (apixaban) versus antiplatelet therapy (aspirin) for secondary stroke prevention.
- To assess the effectiveness of apixaban in patients with cryptogenic stroke and atrial cardiopathy.
Main Methods
- A multicenter, double-blind, randomized phase 3 trial involving 1015 participants.
- Participants had cryptogenic stroke and evidence of atrial cardiopathy, with no atrial fibrillation at randomization.
- Compared apixaban (5 mg or 2.5 mg twice daily) with aspirin (81 mg once daily).
Main Results
- The trial was stopped early for futility after interim analysis.
- Recurrent stroke rates were similar between apixaban and aspirin groups (4.4% annualized rate for both).
- No significant difference in symptomatic intracranial hemorrhage or other major hemorrhages between the groups.
Conclusions
- Apixaban did not significantly reduce the risk of recurrent stroke compared to aspirin in patients with cryptogenic stroke and atrial cardiopathy.
- Current evidence does not support the use of apixaban over aspirin for secondary stroke prevention in this population.
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