Aspirin or Apixaban for Patients with Cryptogenic Ischemic Stroke and History of Cancer?

This underpowered analysis fails to show a difference between aspirin and apixaban after cryptogenic ischemic stroke despite the link between cancer histories and ischemic or hemorrhagic events.

Low-molecular-weight heparin and direct-acting oral anticoagulants are effective for treating cancer-related venous thromboembolism (VTE), but the optimal antithrombotic strategy for malignancy-related cryptogenic stroke without VTE is less clear, especially as these patients are at particularly high risk for hemorrhage with anticoagulation. To learn more, researchers conducted a post hoc secondary analysis of the ARCADIA trial, which had compared apixaban to aspirin for 1015 patients with cryptogenic stroke and atrial cardiopathy (NEJM JW Neurol Mar 14 2024 and JAMA 2024; 331:573).

The current analysis focused on the 137 ARCADIA participants (13.5%) who had reported a history of cancer at enrollment. The composite measure of ischemic or hem…

Reviewing Author

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Aspirin or Apixaban for Patients with Cryptogenic Ischemic Stroke and History of Cancer?

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Reviewing Author