Rivaroxaban Fails in Study of Recurrent Embolic Stroke of Unknown Source

Compared with aspirin, rivaroxaban did not prevent recurrent ischemic strokes and was associated with more bleeding complications.

Embolic stroke of unknown source (ESUS) is diagnosed when the cause is unclear after diagnostic work-up. Because anticoagulants are effective for prevention of stroke related to cardiac emboli, researchers tested their efficacy for ESUS. They randomized 7213 patients (mean age, 67; 62% men) to treatment with either the factor Xa inhibitor rivaroxaban (15 mg daily) or aspirin (100 mg daily). Patients with >50% stenosis of a major vessel supplying the stroke territory were excluded, as were patients with lacunar infarcts, atrial fibrillation, mechanical valves, and left ventricular thrombi. At least 20 hours of cardiac monitoring was required to exclude intermittent atrial fibrillation. The primary outcome was stroke (ischemic or hemorrhagic)…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Rivaroxaban Fails in Study of Recurrent Embolic Stroke of Unknown Source

Topics

Reviewing Author