Anticoagulation
Anticoagulation Treatment Response Among Phenotypic ESUS Clusters: Evidence From CASPR
CASPR registry analysis found no significant overall anticoagulation advantage and no treatment-effect separation by phenotypic cluster.
Deep-Dive: Argatroban in Acute Ischemic Stroke With Early Neurological Deterioration — A 2023 RCT From China
Argatroban + antiplatelet in END (n=601): 90-d mRS 0–3 80.5% vs 73.3% (aRR 1.10, P=0.03); sICH 0.9% vs 0.7% (P=0.78); mRS shift OR 0.71 (P=0.02).
Deep-Dive: Predictors of Hematoma Expansion and Response to Andexanet — ANNEXA-I Secondary Analyses
ANNEXA-I secondary analyses: andexanet benefit amplifies in highest-risk HE quartiles (NNT ~4) without amplifying thrombotic-event risk; authors propose an 11-to-1 rule.
Deep-Dive: Argatroban Plus DAPT in Branch Atherosclerosis Disease — Halves END
Argatroban+DAPT vs DAPT alone in high-risk branch atherosclerosis disease (n=100): END 20.4% vs 47.1% (P=0.006), mRS 0–1 87.8% vs 68.6% (P=0.025), no excess bleeding.
Deep-Dive: ANNEXA-I Biomarker Substudy — Andexanet's Therapeutic Window Is 1 Hour, and It Cuts Both Ways
ANNEXA-I biomarker substudy: 1-hour reduction in anti-FXa (OR 0.69/100 ng/mL) and rise in ETP (OR 0.94/100 nmol/L-min) both predict fewer hematoma expansions; the ETP rise also independently predicts more thrombotic events (OR 1.08).
OPTIMAS — Early vs. Delayed DOAC After Ischemic Stroke, by AF Subtype and Time of Diagnosis
OPTIMAS subgroup analysis: in 3,619 stroke patients with AF, neither the time of AF diagnosis nor AF subtype modifies the effect of early DOAC initiation versus delayed initiation.