The ARCADIA trial, published in JAMA in 2024, compared the efficacy of apixaban versus aspirin in preventing recurrent strokes in patients with cryptogenic stroke and atrial cardiopathy.
Key Findings:
- Primary Outcome: The rate of recurrent stroke was 4.4% in both the apixaban (5 mg or 2.5 mg BD) group and the aspirin (81 mg OD) group, with a hazard ratio of 1.00 (95% CI: 0.64-1.55), indicating no significant difference between the two treatments.
- Secondary Outcome: Symptomatic intracranial hemorrhage occurred in 1.1% of the apixaban group and 0% in the aspirin group.
Conclusion:
In patients with cryptogenic stroke and evidence of atrial cardiopathy without atrial fibrillation, apixaban did not significantly reduce the risk of recurrent stroke compared to aspirin.
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