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

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机构: [1]Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA; [2]Univ Chile, Univ Desarrollo, Clin Alemana Santiago, Santiago, Chile; [3]McMaster Univ, Populat Hlth Res Inst, Dept Med Neurol, Hamilton, ON, Canada; [4]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China; [5]Hosp Badalona Germans Trias & Pujol, Dept Neurosci, Barcelona, Spain; [6]Pirogov Russian Natl Res Med Univ, Moscow, Russia; [7]Ctr Hosp & Univ Coimbra, Coimbra, Portugal; [8]Lund Univ, Skane Univ Hosp, Dept Clin Neurol Sci, Dept Neurol & Rehabil Med, Lund, Sweden; [9]St Annes Univ Hosp, Int Clin Res Ctr, Brno, Czech Republic; [10]St Annes Univ Hosp, Dept Neurol, Brno, Czech Republic; [11]Inst Nacl Neurol & Neurocirug, Mexico City, DF, Mexico; [12]Sigmund Freud Univ, Hosp St John God, Fac Med, Vienna, Austria; [13]Med Univ Warsaw, Inst Psychiat & Neurol, Dept Neurol 2, Warsaw, Poland; [14]Univ Basel, Dept Innere Med, Basel, Switzerland; [15]Irmandade Santa Casa Misericordia Sao Paulo, Sao Paulo, Brazil; [16]Hop Xavier Bichat, Dept Neurol, Paris, France; [17]FLENI, Neurol Res Inst, Buenos Aires, DF, Argentina; [18]Univ Helsinki, Cent Hosp, Dept Neurol, Helsinki, Finland; [19]Imperial Coll London, London, England; [20]Univ Western Australia, Sch Med & Pharmacol, Sir Charles Gairdner Hosp, Perth, WA, Australia; [21]Sapienza Univ Rome, Dept Neurol & Psychiat, Rome, Italy; [22]Semmelweis Univ, Dept Neurol, Budapest, Hungary; [23]Sanno Hosp, Tokyo, Japan; [24]Univ Thessaly, Dept Med, Larisa, Greece; [25]Seoul Natl Univ Hosp, Dept Neurol, Seoul, South Korea; [26]Univ Ziekenhuis Brussel, Brussels, Belgium; [27]Tiervlei Trial Ctr, Cape Town, South Africa; [28]Charite Univ Med Berlin, Ctr Stroke Res Berlin, Klin & Hochschulambulanz Neurol, Berlin, Germany; [29]Univ Glasgow, Queen Elizabeth Univ Hosp, Inst Neurosci & Psychol, Glasgow, Lanark, Scotland; [30]Shaare Zedek Med Ctr, Jerusalem, Israel; [31]Selcuk Univ, Dept Neurol, Konya, Turkey; [32]Natl Univ Ireland, Galway, Ireland; [33]Bayer Pharma AG, Wuppertal, Germany; [34]Bayer Vital, Leverkusen, Germany; [35]McMaster Univ, Thrombosis & Atherosclerosis Res Inst, Hamilton, ON, Canada; [36]Baylor Coll Med, Houston, TX 77030 USA; [37]Populat Hlth Res Inst, Hamilton, ON, Canada; [38]Bayer Pharma AG, Berlin, Germany; [39]Bayer Healthcare Pharmaceut, Parsipanny, NJ USA; [40]Janssen Res & Dev LLC, Spring House, PA USA; [41]McMaster Univ, Populat Hlth Res Inst, Dept Med, Hamilton, ON, Canada; [42]Populat Hlth Res Inst, Hamilton, ON, Canada; [43]McMaster Univ, Dept Med Cardiol, Hamilton Hlth Sci, Hamilton, ON, Canada; [44]McMaster Univ, Populat Hlth Res Inst, Hamilton Hlth Sci, Hamilton, ON, Canada; [45]Univ Penn, Perelman Sch Med, Dept Neurol, 3 West Gates Bldg,3400 Spruce St, Philadelphia, PA 19104 USA
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关键词: Stroke cryptogenic stroke cerebral embolism Embolic Stroke of Undetermined Source (ESUS) stroke prevention rivaroxaban aspirin randomized trial

摘要:
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.

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出版当年[2017]版:
大类 | 4 区 医学
小类 | 4 区 神经科学 4 区 外周血管病
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 神经科学 4 区 外周血管病
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出版当年[2016]版:
Q4 PERIPHERAL VASCULAR DISEASE Q4 NEUROSCIENCES
最新[2024]版:
Q3 PERIPHERAL VASCULAR DISEASE Q4 NEUROSCIENCES

影响因子: 最新[2024版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA;
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通讯机构: [1]Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA; [45]Univ Penn, Perelman Sch Med, Dept Neurol, 3 West Gates Bldg,3400 Spruce St, Philadelphia, PA 19104 USA
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