JAMA N: ESUS patients with left ventricular dysfunction should be the first choice for anticoagulation, not aspirin

Worldwide, approximately 2 million ischemic strokes of unidentified cause occur each year
.

These strokes are classified as cryptogenic and account for approximately 17% of all ischemic strokes

Embolic stroke of unknown origin Anticoagulation in ESUS patients with undetermined origin is not superior to aspirin in reducing the risk of recurrent stroke and systemic embolism

In December 2021, Alexander E.
Merkler et al.
from the United States published the results of a subgroup analysis of the NAVIGATE ESUS randomized clinical trial in JAMA Neurology, with the aim of verifying that anticoagulation therapy is effective in reducing recurrent stroke in patients with ESUS and LV dysfunction.
Is it better than aspirin
.

The NAVIGATE ESUS trial is a randomized Phase 3 clinical trial with enrollment from December 2014 to September 2017
.

459 stroke centers in 31 countries participated in the study

During a median follow-up of 10.
4 months, the study examined the effect of rivaroxaban in reducing (1) primary outcome: recurrent stroke or systemic embolism and (2) secondary outcomes: recurrent stroke, systemic embolism, myocardial infarction or whether it is superior to aspirin in terms of cardiovascular mortality
.

The presence of LV dysfunction was locally determined by echocardiography and defined as moderate to severely impaired global LV contractility and/or regional wall motion abnormalities

Whether rivaroxaban was superior to aspirin in reducing (1) primary outcome: recurrent stroke or systemic embolism and (2) secondary outcome: recurrent stroke, systemic embolism, myocardial infarction, or cardiovascular mortality

The authors concluded that, in this post hoc exploratory analysis, rivaroxaban was superior to aspirin in reducing the risk of recurrent stroke or systemic embolism in ESUS participants with left ventricular dysfunction

Rivaroxaban was superior to aspirin in reducing the risk of recurrent stroke or systemic embolism in ESUS participants with left ventricular dysfunction Ban is better than aspirin

Original source:

Original source:

Alexander E.

Left Ventricular Dysfunction Among Patients With Embolic Stroke of Undetermined Source and the Effect of Rivaroxaban vs Aspirin: A Subgroup Analysis of the NAVIGATE ESUS Randomized Clinical Trial Leave a Comment here