Trial reportStroke2025
Apixaban and Recurrent Stroke Risk With Left Ventricular Dysfunction: A Secondary Analysis of the ARCADIA Trial.
Trial report in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Observational
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Authors and funding
13 authors.
Funding
Abstract
backgroundMajor uncertainty remains about the relationship between left ventricular (LV) systolic dysfunction, recurrent stroke, and the optimal antithrombotic therapy for secondary stroke prevention in patients with recent stroke and LV systolic dysfunction.
methodsWe performed a post hoc analysis of data from the ARCADIA trial (Atrial Cardiopathy and Antithrombotic Drugs in Prevention After Cryptogenic Stroke), a randomized trial comparing apixaban versus aspirin for secondary stroke prevention in patients with cryptogenic stroke and atrial cardiopathy. Echocardiograms were sent from 185 enrolling sites in the United States and Canada for central review at the trial echocardiography laboratory. We defined LV systolic dysfunction as LV fractional shortening <25%, LV ejection fraction <50%, or any LV wall motion abnormality. The primary outcome of interest was recurrent ischemic stroke. First, we built Cox proportional hazard models to evaluate the association between LV systolic dysfunction and recurrent ischemic stroke risk adjusted for imbalanced covariates. Next, we used Cox proportional hazard models and interaction terms to compare the effect of apixaban versus aspirin on the outcome of interest in patients with and without LV systolic dysfunction.
resultsAmong 964 patients with complete echocardiographic data of the 1015 patients enrolled in the trial, 165 (17.1%) had LV systolic dysfunction (mean age, 67 years; 43% female; mean follow-up, 1.7 years), and 799 (82.9%) had no LV systolic dysfunction (mean age, 68 years; 56% female; mean follow-up, 1.5 years). Recurrent ischemic stroke occurred more frequently in patients with LV systolic dysfunction (n=15, 9.1%) compared with those without LV systolic dysfunction (n=50, 6.3%), but LV systolic dysfunction was not significantly associated with recurrent stroke after adjustment for imbalanced covariates (hazard ratio, 1.3 [95% CI, 0.7-2.4]). Compared with aspirin, apixaban was associated with a significantly reduced risk of recurrent ischemic stroke in patients with LV systolic dysfunction (hazard ratio, 0.24 [95% CI, 0.07-0.87]) but not in those without LV systolic dysfunction (hazard ratio, 1.13 [95% CI, 0.65-1.96];
conclusionsIn a secondary analysis of the ARCADIA trial data, apixaban was associated with a significantly lower risk of recurrent ischemic stroke than aspirin in patients with LV systolic dysfunction.
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