{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T06:22:13Z","timestamp":1772950933966,"version":"3.50.1"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>In patients with cryptogenic stroke, the characteristics of multiterritory brain infarcts, the recurrent stroke risk, and the response to anticoagulation remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      The ARCADIA trial (Atrial Cardiopathy and Antithrombotic Drugs in Prevention After Cryptogenic Stroke) screened patients with cryptogenic stroke for atrial cardiopathy at 185 centers in the United States and Canada from 2018 to 2022. Investigators reported baseline acute brain infarction in the left anterior, right anterior, and posterior circulation. Atrial cardiopathy was defined as P-wave terminal force in ECG lead V1s &gt;5000 \u03bcV\u00b7ms, NT-proBNP (N-terminal pro-B-type natriuretic peptide) &gt;250 pg\/mL, or left atrial diameter index \u22653 cm\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Site echocardiography laboratories determined left atrial diameter index and a central echocardiography laboratory determined LVEF. We used ANCOVA to examine whether atrial cardiopathy biomarkers or LVEF were associated with the number of territories with infarction. Cox regression was used to examine whether the number of infarct territories was associated with recurrent stroke or modified the effect of apixaban compared with aspirin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 3464 patients with reported baseline magnetic resonance imaging data, 220 (6.4%) had no visible acute infarct and 2794 (80.7%) had acute infarction in 1, 374 (10.8%) in 2, and 76 (2.2%) in 3 territories. Atrial cardiopathy biomarkers and LVEF were not associated with the number of infarct territories. Among 937 of these 3464 patients who were randomized, we found higher risks of recurrent stroke associated with infarcts in 2 territories (hazard ratio, 2.4 [95% CI, 1.3\u20134.2]) or 3 territories (hazard ratio, 3.7 [95% CI, 1.5\u20139.3]) relative to single-territory infarction, whereas the absence of visible infarction was not associated with recurrence (hazard ratio, 1.8 [95% CI, 0.6\u20134.9]). The number of infarct territories did not modify the effect of apixaban versus aspirin in relation to recurrent stroke (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      for interaction, 0.71).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Multiterritory brain infarction was not associated with atrial cardiopathy biomarkers or LVEF in the ARCADIA trial. Multiterritory infarction was associated with a significantly higher risk of recurrent stroke, but this heightened risk was not reduced by apixaban relative to aspirin.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.125.053079","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T10:00:18Z","timestamp":1764928818000},"page":"570-576","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Multiterritory Brain Infarcts, Anticoagulation, and Recurrence After Cryptogenic Stroke: A Subgroup Analysis of the ARCADIA Trial"],"prefix":"10.1161","volume":"57","author":[{"given":"Rachel","family":"Gologorsky","sequence":"first","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, NY (R.G., N.K., B.B.N., A.L., H.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3545-6927","authenticated-orcid":true,"given":"Maarten G.","family":"Lansberg","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurological Sciences, Stanford Stroke Center, Stanford University, Palo Alto, CA (M.G.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6726-3951","authenticated-orcid":true,"given":"Max","family":"Wintermark","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University of Texas, Austin (M.W.)."},{"name":"MD Anderson Center, Houston, TX (M.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0304-9833","authenticated-orcid":true,"given":"Christy N.","family":"Cassarly","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Medical University of South Carolina, Charleston (C.N.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebeca","family":"Aragon Garcia","sequence":"additional","affiliation":[{"name":"Department of Neurology, Vagelos College of Physicians and Surgeons, New York, NY (R.A.G., M.S.V.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Plummer","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, OH (P.P., J.P.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilushi","family":"Karunamuni","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, NY (R.G., N.K., B.B.N., A.L., H.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0418-6917","authenticated-orcid":true,"given":"Scott E.","family":"Kasner","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Pennsylvania, Philadelphia (S.E.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-6128","authenticated-orcid":true,"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, NY (R.G., N.K., B.B.N., A.L., H.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0184-6035","authenticated-orcid":true,"given":"Ava","family":"Liberman","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, NY (R.G., N.K., B.B.N., A.L., H.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6119-342X","authenticated-orcid":true,"given":"Mukul","family":"Sharma","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University, Hamilton, ON (M.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7323-7709","authenticated-orcid":true,"given":"Joseph P.","family":"Broderick","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, OH (P.P., J.P.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"W.T.","family":"Longstreth","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington, Seattle (W.T.L., D.L.T.)"},{"name":"Department of Medicine, University of Washington, Seattle (W.T.L.)"},{"name":"Department of Epidemiology, University of Washington, Seattle (W.T.L.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8059-2901","authenticated-orcid":true,"given":"David L.","family":"Tirschwell","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington, Seattle (W.T.L., D.L.T.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9897-7076","authenticated-orcid":true,"given":"Richard A.","family":"Kronmal","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Washington, Seattle (R.A.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2562-1156","authenticated-orcid":true,"given":"Mitchell S.V.","family":"Elkind","sequence":"additional","affiliation":[{"name":"Department of Neurology, Vagelos College of Physicians and Surgeons, New York, NY (R.A.G., M.S.V.E.)."},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.S.V.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-0307","authenticated-orcid":true,"given":"Hooman","family":"Kamel","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, NY (R.G., N.K., B.B.N., A.L., H.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the ARCADIA Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.27188"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.0247"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.4905"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24238"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493018799981"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.60.12.1730"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-006-0397-3"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2013.11.039"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12606"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.014178"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.05.014"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2023.09.005"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.3063"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000141703.21173.91"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1376439"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.125.053079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T17:57:45Z","timestamp":1772906265000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.125.053079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1161\/STROKEAHA.125.053079"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.125.053079","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-07-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-21","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}