Characterization of Patients with Embolic Strokes of Undetermined Source in the NAVIGATE ESUS Randomized Trial

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NAVIGATE ESUS Steering Comm 2018 , ' Characterization of Patients with Embolic Strokes of Undetermined Source in the NAVIGATE ESUS Randomized Trial ' , Journal of Stroke & Cerebrovascular Diseases , vol. 27 , no. 6 , pp. 1673-1682 . https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.01.027

Title: Characterization of Patients with Embolic Strokes of Undetermined Source in the NAVIGATE ESUS Randomized Trial
Author: NAVIGATE ESUS Steering Comm
Date: 2018-06
Language: eng
Number of pages: 10
Belongs to series: Journal of Stroke & Cerebrovascular Diseases
ISSN: 1052-3057
URI: http://hdl.handle.net/10138/302414
Abstract: Background: The New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial vs. ASA to Prevent Embolism in Embolic Stroke of Undetermined Source (NAVIGATE-ESUS) trial is a randomized phase-III trial comparing rivaroxaban versus aspirin in patients with recent ESUS. Aims: We aimed to describe the baseline characteristics of this large ESUS cohort to explore relationships among key subgroups. Methods: We enrolled 7213 patients at 459 sites in 31 countries. Prespecified subgroups for primary safety and efficacy analyses included age, sex, race, global region, stroke or transient ischemic attack prior to qualifying event, time to randomization, hypertension, and diabetes mellitus. Results: Mean age was 66.9 +/- 9.8 years; 24% were under 60 years. Older patients had more hypertension, coronary disease, and cancer. Strokes in older subjects were more frequently cortical and accompanied by radiographic evidence of prior infarction. Women comprised 38% of participants and were older than men. Patients from East Asia were oldest whereas those from Latin America were youngest. Patients in the Americas more frequently were on aspirin prior to the qualifying stroke. Acute cortical infarction was more common in the United States, Canada, and Western Europe, whereas prior radiographic infarctions were most common in East Asia. Approximately forty-five percent of subjects were enrolled within 30 days of the qualifying stroke, with earliest enrollments in Asia and Eastern Europe. Conclusions: NAVIGATE-ESUS is the largest randomized trial comparing antithrombotic strategies for secondary stroke prevention in patients with ESUS. The study population encompasses a broad array of patients across multiple continents and these subgroups provide ample opportunities for future research.
Subject: Stroke
cryptogenic stroke
cerebral embolism
Embolic Stroke of Undetermined Source (ESUS)
stroke prevention
rivaroxaban
aspirin
randomized trial
DEFINITION
3112 Neurosciences
3124 Neurology and psychiatry
3121 General medicine, internal medicine and other clinical medicine
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