1. Frequency and patterns of Brain Infarction in Patients With Embolic Stroke of Undetermined Source: NAVIGATE ESUS Trial
- Author
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Sharma, M, Smith, EE, Pearce, LA, Shoamanesh, A, Perera, KS, Coutts, SB, Damgaard, D, Ameriso, SF, Rha, JH, Modrau, B, Yoon, BW, Romano, M, Messe, SR, Barlinn, J, Lambeck, J, Saad, F, Berkowitz, SD, Mundl, H, Connolly, SJ, Hart, RG, Marti-Fabregas, J, and O'Donnell, MJ
- Subjects
embolic stroke ,magnetic resonance imaging ,brain infarction ,tobacco use ,rivaroxaban - Abstract
BACKGROUND AND PURPOSE: The spectrum of brain infarction in patients with embolic stroke of undetermined source (ESUS) has not been well characterized. Our objective was to define the frequency and pattern of brain infarcts detected by magnetic resonance imaging (MRI) among patients with recent ESUS participating in a clinical trial. METHODS: In the NAVIGATE ESUS trial (New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source), an MRI substudy was carried out at 87 sites in 15 countries. Participants underwent an MRI using a specified protocol near randomization. Images were interpreted centrally by those unaware of clinical characteristics. RESULTS: Among the 918 substudy cohort participants, the mean age was 67 years and 60% were men with a median (interquartile range) of 64 (26-115) days between the qualifying ischemic stroke and MRI. On MRI, 855 (93%) had recent or chronic brain infarcts that were multiple in 646 (70%) and involved multiple arterial territories in 62% (401/646). Multiple brain infarcts were present in 68% (510/755) of those without a history of stroke or transient ischemic attack before the qualifying ESUS. Prior stroke/transient ischemic attack (P0 (P
- Published
- 2022