{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T06:03:31Z","timestamp":1779775411578,"version":"3.53.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The relative risks of bleeding with apixaban and aspirin remain unclear. We compared bleeding end points on apixaban versus aspirin in the ARCADIA trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>ARCADIA was a multicenter, double\u2010blind, randomized trial of apixaban versus aspirin in patients with cryptogenic stroke and evidence of atrial cardiopathy. International Society on Thrombosis and Hemostasis (ISTH) criteria were used to classify bleeding as intracranial, symptomatic intracranial, major non\u2010intracranial hemorrhages, and any major and minor hemorrhages. We calculated annualized incidence rate differences (IRDs) between apixaban and aspirin. Our primary analysis included the safety sample which censored patients who permanently stopped taking the study drug. Sensitivity analyses included the intention\u2010to\u2010treat sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1,015 patients assigned to apixaban or aspirin and followed for a mean 1.8 (\u00b11.2) years, 115 (11.3%) patients experienced 146 hemorrhages: 27 (18.5%) major and 119 (81.5%) minor hemorrhages. Apixaban resulted in significantly fewer intracranial hemorrhages than aspirin in both the safety sample (IRD\u2009=\u2009\u22121.4%, 95% confidence interval [CI]\u2009=\u2009\u22122.3% to \u22120.5%) and intention\u2010to\u2010treat sample (IRD\u2009=\u2009\u22121.0%, 95% CI\u2009=\u2009\u22121.8% to \u22120.2%). Findings were similar for the risk of symptomatic intracranial hemorrhage in the safety sample (IRD\u2009=\u2009\u22121.1%, 95% CI\u2009=\u2009\u22121.8% to \u22120.3%), although this was not statistically significant in the sensitivity analysis of the intention\u2010to\u2010treat sample (IRD\u2009=\u2009\u22120.7%, 95% CI\u2009=\u2009\u22121.4% to 0.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.11). Risks of major non\u2010intracranial hemorrhage, any major hemorrhage, and minor hemorrhage did not differ significantly between apixaban and aspirin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>We found no increase in any hemorrhage type and a decrease in intracranial hemorrhage with apixaban relative to aspirin in patients with cryptogenic stroke and evidence of atrial cardiopathy. ANN NEUROL 2026;99:1589\u20131597<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.78186","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:43:56Z","timestamp":1773006236000},"page":"1589-1597","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Apixaban Versus Aspirin and Risk of Hemorrhage in the\n                    <scp>ARCADIA<\/scp>\n                    Trial"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-0307","authenticated-orcid":false,"given":"Hooman","family":"Kamel","sequence":"first","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute Weill Cornell Medicine  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"W. T.","family":"Longstreth","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Washington  Seattle WA"},{"name":"Department of Medicine University of Washington  Seattle WA"},{"name":"Department of Epidemiology University of Washington  Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Tirschwell","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Washington  Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Kronmal","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Washington  Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell S. V.","family":"Elkind","sequence":"additional","affiliation":[{"name":"Department of Neurology Vagelos College of Physicians and Surgeons  New York NY"},{"name":"Department of Epidemiology Mailman School of Public Health, Columbia University  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Pauls","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebeca Aragon","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Neurology Vagelos College of Physicians and Surgeons  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Plummer","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine  Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Sabagha","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine  Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdalla","family":"Ammar","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute Weill Cornell Medicine  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff S.","family":"Healey","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2802-1626","authenticated-orcid":false,"given":"Ashkan","family":"Shoamanesh","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2003-5473","authenticated-orcid":false,"given":"Kevin N.","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Neurology Yale School of Medicine  New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Broderick","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine  Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-6128","authenticated-orcid":false,"given":"Babak B.","family":"Navi","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute Weill Cornell Medicine  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the ARCADIA Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1802686"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1813959"},{"key":"e_1_2_9_4_1","article-title":"Apixaban versus aspirin for embolic stroke of undetermined source","volume":"3","author":"Geisler T","year":"2024","journal-title":"NEJM Evid"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.27188"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.4838"},{"key":"e_1_2_9_7_1","unstructured":"MOSES trial. 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