Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudy

Rivaroxabán; Aspirina; Infart cerebral

Detalles Bibliográficos
Autores: Sharma, Mukul, Smith, Eric, Pearce, Lesly, Perera, Kanjana, Kasner, Scott, Yoon, Byung Woo, Puig, Josep
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:11351/11192
Acceso en línea:https://hdl.handle.net/11351/11192
http://hdl.handle.net/11351/11192
Access Level:acceso abierto
Palabra clave:Anticoagulants
Aspirina
Infart cerebral
CHEMICALS AND DRUGS::Organic Chemicals::Sulfur Compounds::Thiophenes::Rivaroxaban
CHEMICALS AND DRUGS::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Benzene Derivatives::Phenols::Hydroxybenzoates::Salicylates::Aspirin
DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia::Brain Infarction
COMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::compuestos de azufre::tiofenos::rivaroxabán
COMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::hidrocarburos::hidrocarburos cíclicos::hidrocarburos aromáticos::derivados del benceno::fenoles::hidroxibenzoatos::salicilatos::aspirina
ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral::infarto encefálico::infarto cerebral
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oai_identifier_str oai:recercat.cat:11351/11192
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudy
title Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudy
spellingShingle Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudy
Sharma, Mukul
Anticoagulants
Aspirina
Infart cerebral
CHEMICALS AND DRUGS::Organic Chemicals::Sulfur Compounds::Thiophenes::Rivaroxaban
CHEMICALS AND DRUGS::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Benzene Derivatives::Phenols::Hydroxybenzoates::Salicylates::Aspirin
DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia::Brain Infarction
COMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::compuestos de azufre::tiofenos::rivaroxabán
COMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::hidrocarburos::hidrocarburos cíclicos::hidrocarburos aromáticos::derivados del benceno::fenoles::hidroxibenzoatos::salicilatos::aspirina
ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral::infarto encefálico::infarto cerebral
title_short Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudy
title_full Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudy
title_fullStr Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudy
title_full_unstemmed Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudy
title_sort Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudy
dc.creator.none.fl_str_mv Sharma, Mukul
Smith, Eric
Pearce, Lesly
Perera, Kanjana
Kasner, Scott
Yoon, Byung Woo
Puig, Josep
author Sharma, Mukul
author_facet Sharma, Mukul
Smith, Eric
Pearce, Lesly
Perera, Kanjana
Kasner, Scott
Yoon, Byung Woo
Puig, Josep
author_role author
author2 Smith, Eric
Pearce, Lesly
Perera, Kanjana
Kasner, Scott
Yoon, Byung Woo
Puig, Josep
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Institut Català de la Salut
[Sharma M] Department of Medicine (Neurology), McMaster University, Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada. [Smith EE] Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada. [Pearce LA] St. Catharines, Ontario, Canada. [Perera KS] Department of Medicine (Neurology), McMaster University, Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada. [Kasner SE] Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA. [Yoon BW] Department of Neurology, Seoul National University Hospital, Seoul, Korea. [Puig J] Department of Radiology, Girona Biomedical Research Institute, Hospital Universitari de Girona Dr. Josep Trueta, Institut Català de la Salut (ICS), Girona, Spain
Departament de Salut
dc.subject.none.fl_str_mv Anticoagulants
Aspirina
Infart cerebral
CHEMICALS AND DRUGS::Organic Chemicals::Sulfur Compounds::Thiophenes::Rivaroxaban
CHEMICALS AND DRUGS::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Benzene Derivatives::Phenols::Hydroxybenzoates::Salicylates::Aspirin
DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia::Brain Infarction
COMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::compuestos de azufre::tiofenos::rivaroxabán
COMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::hidrocarburos::hidrocarburos cíclicos::hidrocarburos aromáticos::derivados del benceno::fenoles::hidroxibenzoatos::salicilatos::aspirina
ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral::infarto encefálico::infarto cerebral
topic Anticoagulants
Aspirina
Infart cerebral
CHEMICALS AND DRUGS::Organic Chemicals::Sulfur Compounds::Thiophenes::Rivaroxaban
CHEMICALS AND DRUGS::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Benzene Derivatives::Phenols::Hydroxybenzoates::Salicylates::Aspirin
DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia::Brain Infarction
COMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::compuestos de azufre::tiofenos::rivaroxabán
COMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::hidrocarburos::hidrocarburos cíclicos::hidrocarburos aromáticos::derivados del benceno::fenoles::hidroxibenzoatos::salicilatos::aspirina
ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral::infarto encefálico::infarto cerebral
description Rivaroxabán; Aspirina; Infart cerebral
publishDate 2021
dc.date.none.fl_str_mv 2021
2022
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/11351/11192
http://hdl.handle.net/11351/11192
url https://hdl.handle.net/11351/11192
http://hdl.handle.net/11351/11192
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Stroke;17(7)
https://doi.org/10.1177/17474930211058012
dc.rights.none.fl_str_mv Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sage Publications
publisher.none.fl_str_mv Sage Publications
dc.source.none.fl_str_mv Scientia
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869410772840349696
spelling Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source: NAVIGATE ESUS MRI substudySharma, MukulSmith, EricPearce, LeslyPerera, KanjanaKasner, ScottYoon, Byung WooPuig, JosepAnticoagulantsAspirinaInfart cerebralCHEMICALS AND DRUGS::Organic Chemicals::Sulfur Compounds::Thiophenes::RivaroxabanCHEMICALS AND DRUGS::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Benzene Derivatives::Phenols::Hydroxybenzoates::Salicylates::AspirinDISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia::Brain InfarctionCOMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::compuestos de azufre::tiofenos::rivaroxabánCOMPUESTOS QUÍMICOS Y DROGAS::compuestos orgánicos::hidrocarburos::hidrocarburos cíclicos::hidrocarburos aromáticos::derivados del benceno::fenoles::hidroxibenzoatos::salicilatos::aspirinaENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral::infarto encefálico::infarto cerebralRivaroxabán; Aspirina; Infart cerebralRivaroxabán; Aspirina; Infarto cerebralRivaroxabán; Aspirin; Brain infarctBackground: Covert brain infarcts are associated with important neurological morbidity. Their incidence in patients with embolic stroke of undetermined source (ESUS) is unknown. Aims: To assess the incidence of covert brain infarcts and cerebral microbleeds using MRI in a prospective substudy of the NAVIGATE ESUS randomized trial and to evaluate the effects of antithrombotic therapies. Methods: At 87 sites in 15 countries, substudy participants were randomly assigned to receive rivaroxaban 15 mg daily or aspirin 100 mg daily and underwent brain MRI near randomization and after study termination. The primary outcome was incident brain infarct (clinical ischemic stroke or covert brain infarct). Brain infarcts and microbleeds were ascertained centrally by readers unaware of treatment. Treatment effects were estimated using logistic regression. Results: Among the 718 substudy participants with interpretable, paired MRIs, the mean age was 67 years and 61% were men with a median of 52 days between the qualifying ischemic stroke and randomization and a median of seven days between randomization and baseline MRI. During the median (IQR) 11 (12) month interval between scans, clinical ischemic strokes occurred in 27 (4%) participants, while 60 (9%) of the remaining participants had an incident covert brain infarct detected by MRI. Assignment to rivaroxaban was not associated with reduction in the incidence of brain infarct (OR 0.77, 95% CI 0.49, 1.2) or of covert brain infarct among those without clinical stroke (OR 0.85, 95% CI 0.50, 1.4). New microbleeds were observed in 7% and did not differ among those assigned rivaroxaban vs. aspirin (HR 0.95, 95% CI 0.52-1.7). Conclusions: Incident covert brain infarcts occurred in twice as many ESUS patients as a clinical ischemic stroke. Treatment with rivaroxaban compared with aspirin did not significantly reduce the incidence of covert brain infarcts or increase the incidence of microbleeds, but the confidence intervals for treatment effects were wide.Registration: https://www.clinicaltrials.gov. Unique identifier: NCT02313909.The NAVIGATE ESUS trial and the MRI Substudy were sponsored by Bayer AG.Sage PublicationsInstitut Català de la Salut[Sharma M] Department of Medicine (Neurology), McMaster University, Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada. [Smith EE] Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada. [Pearce LA] St. Catharines, Ontario, Canada. [Perera KS] Department of Medicine (Neurology), McMaster University, Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada. [Kasner SE] Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA. [Yoon BW] Department of Neurology, Seoul National University Hospital, Seoul, Korea. [Puig J] Department of Radiology, Girona Biomedical Research Institute, Hospital Universitari de Girona Dr. Josep Trueta, Institut Català de la Salut (ICS), Girona, SpainDepartament de Salut2024202420212022info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/11351/11192http://hdl.handle.net/11351/11192Scientiareponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésInternational Journal of Stroke;17(7)https://doi.org/10.1177/17474930211058012Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:11351/111922026-05-29T05:05:01Z
score 15,812429

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