Rivaroxaban vs Warfarin Sodium in the Ultra-Early Period After Atrial Fibrillation–Related Mild Ischemic Stroke A Randomized Clinical Trial -

Rivaroxaban vs Warfarin Sodium in the Ultra-Early Period After Atrial Fibrillation–Related Mild Ischemic Stroke A Randomized Clinical Trial
Information type: Randomised controlled trials
Source: JAMA Neurology
Specialities: Haematological disorders | Neurological disorders | Stroke
Summary
This RCT (n=195) reports in patients with mild acute ischaemic stroke and AF, new ischaemic lesions or intracranial haemorrhage (noted on MRI imaging) after 4 weeks occurred in 49.5% of patients receiving rivaroxaban v 54.5% receiving warfarin (nonsignificant difference, p=0.49).
UKMi comment

In a related editorial, the author discusses the findings of this Triple AXEL trial shows that starting anticoagulation for AF with warfarin or rivaroxaban at a median of 2 days after mild acute stroke did not lead to a high risk of symptomatic intracranial haemorrhage or a detectable reduction in early ischaemic stroke. “Early anticoagulation with a direct oral anticoagulant and warfarin in patients with mild stroke is feasible, but whether this is of benefit to all patients with acute stroke and AF has yet to be demonstrated”.
Related links: Editorial