Potential Future Role for Anticoagulants in Stroke Prevention After ESUS

Patients with embolic stroke of unknown source who have a high risk for atrial fibrillation may benefit from anticoagulation.

The clinical conditions for which oral anticoagulant (OAC) medications are best established for stroke prevention are atrial fibrillation (AF) and mechanical heart valves. Some patients have embolic-appearing strokes without definite documentation of a high-risk embolic source, leading to the concept of embolic stroke of unknown source (ESUS). Is it possible that some ESUS patients will benefit from anticoagulation?

These investigators analyzed 7112 patients (mean age, 67; 62% male) who participated in the NAVIGATE ESUS randomized trial, which showed no difference in stroke with factor Xa inhibitor rivaroxaban versus aspirin in patients with ESUS overall. To evaluate potential subgroups with increased risk for embolic events, the investigato…

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

Potential Future Role for Anticoagulants in Stroke Prevention After ESUS

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Reviewing Author