Abstract | BACKGROUND AND PURPOSE: METHODS: Baseline and follow-up magnetic resonance imagings were completed in 1445 participants with a mean (SD) interval of 2.0 (0.7) years. Whole-brain T1, T2 fluid-attenuated inversion recovery, T2* sequences were centrally interpreted by blinded, trained readers. Participants had serial measurements of cognition and function. The primary end point was the proportion of participants with incident covert infarcts. Secondary end points were the composite of clinical stroke and covert brain infarcts, cerebral microbleeds, and white matter hyperintensities. RESULTS: At baseline, 493 (34.1%) participants had infarcts. Incident covert infarcts occurred in 55 (3.8%) participants. In the overall trial rivaroxaban plus aspirin reduced ischemic stroke by 49% (0.7% versus 1.4%; hazard ratio [95% CI], 0.51 [0.38-0.68]). In the magnetic resonance imaging substudy the effects of rivaroxaban+aspirin versus aspirin were: covert infarcts: 2.7% versus 3.5% (odds ratio [95% CI], 0.77 [0.37-1.60]); Covert infarcts or ischemic stroke: 2.9% versus 5.3% (odds ratio [95% CI], 0.53 [0.27-1.03]). Incident microbleeds occurred in 6.6% of participants and 65.7% of participants had an increase in white matter hyperintensities volume with no effect of treatment for either end point. There was no effect on cognitive tests. CONCLUSIONS:
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Authors | Mukul Sharma, Robert G Hart, Eric E Smith, Jacqueline Bosch, John W Eikelboom, Stuart J Connolly, Leanne Dyal, Kevin W Reeh, Amparo Casanova, Rafael Diaz, Patricio Lopez-Jaramillo, Georg Ertl, Stefan Störk, Gilles R Dagenais, Eva M Lonn, Lars Ryden, Andrew M Tonkin, John D Varigos, Deepak L Bhatt, Kelley R H Branch, Jeffrey L Probstfield, Jae-Hyung Kim, Martin O'Donnell, Dragos Vinereanu, Keith A A Fox, Yan Liang, Lisheng Liu, Jun Zhu, Nana Pogosova, Aldo P Maggioni, Alvaro Avezum, Leopoldo S Piegas, Katalin Keltai, Matyas Keltai, Scott D Berkowitz, Salim Yusuf |
Journal | Stroke
(Stroke)
Vol. 51
Issue 10
Pg. 2901-2909
(10 2020)
ISSN: 1524-4628 [Electronic] United States |
PMID | 32951537
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Factor Xa Inhibitors
- Platelet Aggregation Inhibitors
- Rivaroxaban
- Aspirin
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Topics |
- Aged
- Aspirin
(therapeutic use)
- Brain
(diagnostic imaging)
- Brain Infarction
(complications, diagnostic imaging, prevention & control)
- Cognitive Dysfunction
(diagnostic imaging, etiology, prevention & control)
- Drug Therapy, Combination
- Factor Xa Inhibitors
(therapeutic use)
- Female
- Humans
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Platelet Aggregation Inhibitors
(therapeutic use)
- Rivaroxaban
(therapeutic use)
- Stroke
(complications, diagnostic imaging, prevention & control)
- Treatment Outcome
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