{"id":62750,"date":"2024-02-19T13:42:10","date_gmt":"2024-02-19T08:12:10","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=62750"},"modified":"2024-02-19T15:33:33","modified_gmt":"2024-02-19T10:03:33","slug":"arcadia-trial-on-atrial-cardiopathy-and-stroke","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/arcadia-trial-on-atrial-cardiopathy-and-stroke\/","title":{"rendered":"ARCADIA Trial on Atrial Cardiopathy and Stroke"},"content":{"rendered":"<p><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/b2U8WU6vIVQ?si=d1Mss0eVgpQTDEqz\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><br \/>\nIn an earlier post on <a href=\"https:\/\/johnsonfrancis.org\/professional\/embolic-stroke-of-undetermined-source-esus\/\">Embolic Stroke of Undetermined Source (ESUS)<\/a>, I had mentioned about ARCADIA trial (AtRial Cardiopathy and Antithrombotic Drugs In Prevention After Cryptogenic Stroke) which was testing whether there is role for apixaban compared to aspirin for prevention of recurrent stroke in ESUS. The trial was sponsored by the National Institutes of Health, United States of America and the results have been published in February 2024. ARCADIA trial showed that in patients with cryptogenic stroke and atrial cardiopathy, apixaban did not reduce the risk of recurrent stroke compared with low dose aspirin. The study was conducted in patients with cryptogenic ischemic stroke and evidence of atrial cardiopathy, but without atrial fibrillation.<\/p>\n<p>It was a multicenter, randomized, double blind, double dummy trial involving 1000 odd patients within 180 days of stroke and mean follow up period was 1.8 years. Median time post stroke to randomization was 50 days. Atrial cardiopathy was defined based on one or more of ECG, NT-ProBNP and indexed left atrial diameter criteria. In ECG, V1 P-terminal force more than 5000 \u00b5V\u00b7ms was the cut off. Serum NT-proBNP cut off was more than 250 pg\/mL. Indexed left atrial diameter \u22653 cm\/m<sup>2<\/sup> on transthoracic echocardiography was the echocardiographic criteria.<\/p>\n<div class=\"description\">\n<p>Though atrial cardiopathy has been associated with stroke in the absence of clinically apparent atrial fibrillation, ARCADIA trial did not prove the benefit of anticoagulation with apixaban in preventing recurrence compared to aspirin.<\/p>\n<\/div>\n<div class=\"contribution-to-literature\">\n<p><span style=\"color: #0000ff;\"><strong>Reference<\/strong><\/span><\/p>\n<ol>\n<li>Kamel H, Longstreth WT Jr, Tirschwell DL, Kronmal RA, Marshall RS, Broderick JP, Arag\u00f3n Garc\u00eda R, Plummer P, Sabagha N, Pauls Q, Cassarly C, Dillon CR, Di Tullio MR, Hod EA, Soliman EZ, Gladstone DJ, Healey JS, Sharma M, Chaturvedi S, Janis LS, Krishnaiah B, Nahab F, Kasner SE, Stanton RJ, Kleindorfer DO, Starr M, Winder TR, Clark WM, Miller BR, Elkind MSV; ARCADIA Investigators. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38324415\/\">Apixaban to Prevent Recurrence After Cryptogenic Stroke in Patients With Atrial Cardiopathy: The ARCADIA Randomized Clinical Trial<\/a>. JAMA. 2024 Feb 7:e2327188. doi: 10.1001\/jama.2023.27188. Epub ahead of print. PMID: 38324415; PMCID: PMC10851142.<\/li>\n<\/ol>\n<\/div>\n<div class=\"description\"><\/div>\n","protected":false},"excerpt":{"rendered":"<p>In an earlier post on Embolic Stroke of Undetermined Source (ESUS), I had mentioned about ARCADIA trial (AtRial Cardiopathy and Antithrombotic Drugs In Prevention After Cryptogenic Stroke) which was testing whether there is role for apixaban compared to aspirin for prevention of recurrent stroke in ESUS. The trial was sponsored by the National Institutes of [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":62757,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-62750","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ARCADIA Trial on Atrial Cardiopathy and Stroke - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/arcadia-trial-on-atrial-cardiopathy-and-stroke\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ARCADIA Trial on Atrial Cardiopathy and Stroke - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"In an earlier post on Embolic Stroke of Undetermined Source (ESUS), I had mentioned about ARCADIA trial (AtRial Cardiopathy and Antithrombotic Drugs In Prevention After Cryptogenic Stroke) which was testing whether there is role for apixaban compared to aspirin for prevention of recurrent stroke in ESUS. 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