Imperial College London
Alternate

ProfessorRolandVeltkamp

Faculty of Medicine, Department of Brain Sciences

Professor of Neurology and Chair of Stroke Medicine
 
 
 
//

Contact

 

r.veltkamp

 
 
//

Location

 

3 East6East WingCharing Cross Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Hart:2018:10.1056/NEJMoa1802686,
author = {Hart, RG and Sharma, M and Mundl, H and Kasner, SE and Bangdiwala, SI and Berkowitz, SD and Swaminathan, B and Lavados, P and Wang, Y and Wang, Y and Davalos, A and Shamalov, N and Mikulik, R and Cunha, L and Lindgren, A and Arauz, A and Lang, W and Czlonkowska, A and Eckstein, J and Gagliardi, RJ and Amarenco, P and Ameriso, SF and Tatlisumak, T and Veltkamp, R and Hankey, GJ and Toni, D and Bereczki, D and Uchiyama, S and Ntaios, G and Yoon, B-W and Brouns, R and Endres, M and Muir, KW and Bornstein, N and Ozturk, S and O'Donnell, MJ and Basson, MMDV and Pare, G and Pater, C and Kirsch, B and Sheridan, P and Peters, G and Weitz, JI and Peacock, WF and Shoamanesh, A and Benavente, OR and Joyner, C and Themeles, E and Connolly, SJ},
doi = {10.1056/NEJMoa1802686},
journal = {New England Journal of Medicine},
pages = {2191--2201},
title = {Rivaroxaban for stroke prevention after embolic stroke of undetermined source},
url = {http://dx.doi.org/10.1056/NEJMoa1802686},
volume = {378},
year = {2018}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundEmbolic strokes of undetermined source represent 20% of ischemic strokes and are associated with a high rate of recurrence. Anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, may result in a lower risk of recurrent stroke than aspirin.MethodsWe compared the efficacy and safety of rivaroxaban (at a daily dose of 15 mg) with aspirin (at a daily dose of 100 mg) for the prevention of recurrent stroke in patients with recent ischemic stroke that was presumed to be from cerebral embolism but without arterial stenosis, lacune, or an identified cardioembolic source. The primary efficacy outcome was the first recurrence of ischemic or hemorrhagic stroke or systemic embolism in a time-to-event analysis; the primary safety outcome was the rate of major bleeding.ResultsA total of 7213 participants were enrolled at 459 sites; 3609 patients were randomly assigned to receive rivaroxaban and 3604 to receive aspirin. Patients had been followed for a median of 11 months when the trial was terminated early because of a lack of benefit with regard to stroke risk and because of bleeding associated with rivaroxaban. The primary efficacy outcome occurred in 172 patients in the rivaroxaban group (annualized rate, 5.1%) and in 160 in the aspirin group (annualized rate, 4.8%) (hazard ratio, 1.07; 95% confidence interval [CI], 0.87 to 1.33; P=0.52). Recurrent ischemic stroke occurred in 158 patients in the rivaroxaban group (annualized rate, 4.7%) and in 156 in the aspirin group (annualized rate, 4.7%). Major bleeding occurred in 62 patients in the rivaroxaban group (annualized rate, 1.8%) and in 23 in the aspirin group (annualized rate, 0.7%) (hazard ratio, 2.72; 95% CI, 1.68 to 4.39; P<0.001).ConclusionsRivaroxaban was not superior to aspirin with regard to the prevention of recurrent stroke after an initial embolic stroke of undetermined source and was associated with a higher risk of bleeding. (Funded by Bayer and Janssen Research and Development; NAVIGATE
AU  - Hart,RG
AU  - Sharma,M
AU  - Mundl,H
AU  - Kasner,SE
AU  - Bangdiwala,SI
AU  - Berkowitz,SD
AU  - Swaminathan,B
AU  - Lavados,P
AU  - Wang,Y
AU  - Wang,Y
AU  - Davalos,A
AU  - Shamalov,N
AU  - Mikulik,R
AU  - Cunha,L
AU  - Lindgren,A
AU  - Arauz,A
AU  - Lang,W
AU  - Czlonkowska,A
AU  - Eckstein,J
AU  - Gagliardi,RJ
AU  - Amarenco,P
AU  - Ameriso,SF
AU  - Tatlisumak,T
AU  - Veltkamp,R
AU  - Hankey,GJ
AU  - Toni,D
AU  - Bereczki,D
AU  - Uchiyama,S
AU  - Ntaios,G
AU  - Yoon,B-W
AU  - Brouns,R
AU  - Endres,M
AU  - Muir,KW
AU  - Bornstein,N
AU  - Ozturk,S
AU  - O'Donnell,MJ
AU  - Basson,MMDV
AU  - Pare,G
AU  - Pater,C
AU  - Kirsch,B
AU  - Sheridan,P
AU  - Peters,G
AU  - Weitz,JI
AU  - Peacock,WF
AU  - Shoamanesh,A
AU  - Benavente,OR
AU  - Joyner,C
AU  - Themeles,E
AU  - Connolly,SJ
DO  - 10.1056/NEJMoa1802686
EP  - 2201
PY  - 2018///
SN  - 0028-4793
SP  - 2191
TI  - Rivaroxaban for stroke prevention after embolic stroke of undetermined source
T2  - New England Journal of Medicine
UR  - http://dx.doi.org/10.1056/NEJMoa1802686
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000434263000007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/75173
VL  - 378
ER  -
Download