{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T17:22:18Z","timestamp":1793467338694,"version":"4.5.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T00:00:00Z","timestamp":1536537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"BMS-Pfizer Alliance"},{"DOI":"10.13039\/100016545","name":"Roche Diagnostics","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016545","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["1U01NS095869"],"award-info":[{"award-number":["1U01NS095869"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Recent data suggest that a thrombogenic atrial substrate can cause stroke in the absence of atrial fibrillation. Such an atrial cardiopathy may explain some proportion of cryptogenic strokes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of the ARCADIA trial is to test the hypothesis that apixaban is superior to aspirin for the prevention of recurrent stroke in subjects with cryptogenic ischemic stroke and atrial cardiopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample size estimate<\/jats:title>\n                    <jats:p>1100 participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and design<\/jats:title>\n                    <jats:p>Biomarker-driven, randomized, double-blind, active-control, phase 3 clinical trial conducted at 120 U.S. centers participating in NIH StrokeNet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population studied<\/jats:title>\n                    <jats:p>\n                      Patients\u2009\u2265\u200945 years of age with embolic stroke of undetermined source and evidence of atrial cardiopathy, defined as\u2009\u2265\u20091 of the following markers: P-wave terminal force &gt;5000\u2009\u00b5V\u2009\u00d7\u2009ms in ECG lead V\n                      <jats:sub>1<\/jats:sub>\n                      , serum NT-proBNP\u2009&gt;\u2009250\u2009pg\/mL, and left atrial diameter index\u2009\u2265\u20093\u2009cm\/m\n                      <jats:sup>2<\/jats:sup>\n                      on echocardiogram. Exclusion criteria include any atrial fibrillation, a definite indication or contraindication to antiplatelet or anticoagulant therapy, or a clinically significant bleeding diathesis. Intervention: Apixaban 5\u2009mg twice daily versus aspirin 81\u2009mg once daily. Analysis: Survival analysis and the log-rank test will be used to compare treatment groups according to the intention-to-treat principle, including participants who require open-label anticoagulation for newly detected atrial fibrillation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study outcomes<\/jats:title>\n                    <jats:p>The primary efficacy outcome is recurrent stroke of any type. The primary safety outcomes are symptomatic intracranial hemorrhage and major hemorrhage other than intracranial hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>ARCADIA is the first trial to test whether anticoagulant therapy reduces stroke recurrence in patients with atrial cardiopathy but no known atrial fibrillation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1747493018799981","type":"journal-article","created":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T03:41:58Z","timestamp":1536550918000},"page":"207-214","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":357,"title":["The AtRial Cardiopathy and Antithrombotic Drugs In prevention After cryptogenic stroke randomized trial: Rationale and methods"],"prefix":"10.1177","volume":"14","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, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medical College, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"WT","family":"Longstreth","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington, Seattle, WA, USA"},{"name":"Department of Medicine, University of Washington, Seattle, WA, USA"},{"name":"Department of Epidemiology, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L","family":"Tirschwell","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington, Seattle, WA, USA"}],"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":"Joseph P","family":"Broderick","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko Y","family":"Palesch","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlyn","family":"Meinzer","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, 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