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AAN 2022 | Direct oral anticoagulants after stroke: ongoing clinical trials

Edip Gurol, MD, Massachusetts General Hospital and Harvard Medical School, Boston, MA, outlines ongoing clinical trials assessing the use of direct oral anticoagulants after stroke. The APACHE-AF (NCT02565693) and the ENRICH-AF (NCT03950076) studies might provide additional information on the use of direct oral anticoagulants after cerebral hemorrhage. Additionally, three ongoing studies in Europe are comparing left atrial appendage (LAA) closure with oral anticoagulants in patients with atrial fibrillation who sustained a brain bleed. Several clinical trials are evaluating the use of direct oral anticoagulants in patients with cryptogenic stroke. The ATTICUS study (NCT02427126) comparing apixaban to acetylsalicylic acid for the treatment of embolic stroke of undetermined source was recently stopped. The ARCADIA study (NCT03192215) is testing the hypothesis that apixaban is superior to aspirin for the prevention of recurrent stroke in patients with cryptogenic ischemic stroke and atrial cardiopathy. Overall, efforts are underway to better understand the challenges and failures of medications in preventing stroke in patients with atrial fibrillation. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.

Disclosures

Research grant to hospital: AVID, BSC, Pfizer