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Aiming to reduce recurrent stroke in patients with embolic stroke of unknown source (ESUS), recent trials have compared direct oral anticoagulants (DOACs) to aspirin, but results have been neutral. For example, the ARCADIA trial compared apixaban versus aspirin in patients with ESUS and evidence of atrial cardiopathy, finding no difference. Now, researchers report results of an MRI substudy of ARCADIA, in which patients underwent a baseline and end-of-study MRI. This analysis compares the rate of MRI-detected covert (silent), nonlacunar stroke in the two treatment groups.
Of the 1015 patients in the parent trial, 310 patients enrolled in the MRI substudy, of whom 174 patients had image quality sufficient for analysis. In these 174 patients (…