June 2018 PMID 29766772

Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source.

Robert G Hart, Mukul Sharma, Hardi Mundl, Scott E Kasner, Shrikant I Bangdiwala, Scott D Berkowitz, Balakumar Swaminathan, Pablo Lavados, Yongjun Wang, Yilong Wang, Antonio Davalos, Nikolay Shamalov, Robert Mikulik, Luis Cunha, Arne Lindgren

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Mentions

Peak: 3 in Apr 2019

across 6 sources since Jul 2018

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64,217

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1,056

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Jul 2018 – Feb 2025

Where it's discussed

Facebook33 posts
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News14 articles
Blogs4 articles
YouTube3 videos
Bluesky1 posts

AI synopsis

What people are saying

The collective discussions highlight the consistent finding that rivaroxaban offers no significant benefit over aspirin in preventing recurrent strokes but increases bleeding risk, with comments referencing major trials like NAVIGATE-ESUS and RESPECT-ESUS. The tone varies between clinical analysis and cautious skepticism, reflecting nuanced engagement with the research and its implications.

AgreementNeither agree nor disagree

Most discussions reflect acknowledgment of the study's findings that rivaroxaban isn't superior to aspirin and has higher bleeding risks, showing mixed opinions about the significance.

InterestModerate interest

The posts demonstrate moderate interest, with many referencing major trials and the implications for clinical practice.

EngagementModerate engagement

Several discussions delve into trial details, clinical implications, and comparisons with other anticoagulants, indicating active engagement.

ImpactModerate impact

Given the emphasis on clinical trial results and potential influence on treatment decisions, these discussions have moderate to high impact on medical practice.

Abstract in brief

Embolic strokes of undetermined source account for 20% of ischemic strokes and have a high recurrence rate; the study compared rivaroxaban, an oral anticoagulant, against aspirin for preventing these recurrences.
In a trial with 7213 participants, rivaroxaban did not show significant benefits over aspirin in preventing recurrent strokes, with similar rates of recurrence observed in both treatment groups.
However, patients taking rivaroxaban experienced a substantially higher rate of major bleeding compared to those on aspirin, leading to the conclusion that rivaroxaban is not a better option for preventing recurrent strokes in this patient population.

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All mentions

AF Ablation Trials and Stroke Prevention Insights

This week, John Mandrola MD discusses important findings from recent AF ablation trials and emphasizes the significance of RCTs, particularly in the context of cryptogenic strokes. He reviews the comparative…

Medscape · Jan 31, 2025 603 views

Cerebral Embolism and Antithrombotic Strategies in AF and CAD

Silent cerebral embolism and antithrombotic strategies in patients with AF and CAD are the focus of this podcast featuring John Mandrola MD. Explore the implications of recent studies on stroke prevention and management…

Medscape · Feb 14, 2025 441 views

Analyzing Stroke Prevention in Cryptogenic Stroke Patients

This episode discusses the efficacy of dabigatran versus aspirin in preventing recurrent strokes among patients with cryptogenic strokes. Recent trial results show no significant advantage of dabigatran over aspirin…

Medscape · Mar 27, 2024 12 views

Ismail Raslan

@itraslan · X

@drjohnm @EJSMD @venkmurthy Time to meta-analyze. I generally agree and counsel patients as such, but ICH was worse with Riva 15 in NAVIGATE (flaws and all etc..). https://t.co/5QdgKVOqOm https://t.co/cvU4MBp0GP

Feb 9, 2024 · 522 followers View post →

Umar Shakur

@u_shakur · X

2/4 …series of trials, beginning with rivaroxaban (https://t.co/91EedGQx17) in 2018, then dabigatran (https://t.co/ScOtOHPrtp) in 2019 found that neither drug was superior to aspirin. Now we have apixaban, which also failed to show any benefit over aspirin. They added a twist,

Jan 6, 2024 · 292 followers View post →

Jesús F Sierra

@quequesierra · X

@Gustavo22205004 @LorenVillato Sus palabras son incorrectas. Hay más indicaciones en las que los ACOD han fallado que en las que han resultado. Le dejo algo de bibliografía por si desea documentarse. Un saludo: https://t.co/HvrqGCsKrO https://t.co/rGEo5QFyZQ https://t.co/DKig2sFT0z https://t.co/aOwEbRgnfO

Dec 27, 2023 · 1 like · 527 followers View post →

Matias Rodriguez G

@matiasrg · X

@AguilarMolina_ @jsenior64 @gonzaeperez @adribaran @SposatoL El ⚖️ entre el

Apr 1, 2023 · 2 likes · 1,392 followers View post →

Champion the Challenges

@champchallenges · X

Rivaroxaban for Stroke Prevention after Embolic #Stroke of Undetermined Source - read more - https://t.co/0dyvEP0pVt

Jan 25, 2022 · 165 followers View post →

Pratiek

@drshahpratik74 · X

RT @NEJM: Original Article: Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source (NAVIGATE ESUS) https://t.co/CW9d…

Dec 7, 2021 · 149 shares · 1,051 followers View post →

Docjuanfra

@Docjuanfra · X

RT @WorldStrokeEd: #WeekendLecture #ESUS Benefits from #anticoagulation hypothesis was studied in 2 RCT

Jul 4, 2021 · 3 shares · 286 followers View post →

Shadi Yaghi

@ShadiYaghi2 · X

RT @WorldStrokeEd: #WeekendLecture #ESUS Benefits from #anticoagulation hypothesis was studied in 2 RCT

Jul 4, 2021 · 3 shares · 7,593 followers View post →

World Stroke Academy

@WorldStrokeEd · X

#WeekendLecture #ESUS Benefits from #anticoagulation hypothesis was studied in 2 RCT

Jul 4, 2021 · 18 likes · 3 shares · 14,415 followers View post →

Nicolas Renna, MD PhD ISHF FESC

@nicolasrennamd · X

RT @onlineIJCS: #5 - It’s notewworthy that so far, trials that tested DOACS for ESUS were not superior to aspirin and even increased bleedi…

May 30, 2021 · 1 share · 934 followers View post →

International Journal of Cardiovascular Sciences

@onlineIJCS · X

#5 - It’s notewworthy that so far, trials that tested DOACS for ESUS were not superior to aspirin and even increased bleeding. See references: https://t.co/Z23LyQ6TAv and https://t.co/WjLtw8srgb

May 30, 2021 · 3 likes · 1 share · 637 followers View post →

JK Han MD

@netta_doc · X

Feb 26, 2021 · 2 likes · 8,089 followers View post →

Lourdes Ramírez E

@Geriatrizando · X

Rivaroxabán 15mg como prevención secundaria de EVC criptogénico no fue superior a Aspirina en la disminución de eventos isquémicos, pero incrementó el riesgo de sangrado significativamente. HR 2.72 (IC95% 1.68-4.39) https://t.co/w3f1X2ZzZm https://t.co/JHGD51udiq

Aug 2, 2020 · 167 followers View post →

Prash Sanders

@PrashSanders · X

RT @netta_doc: Important papers to reference - both NAVIGATE-ESUS and RESPECT-ESUS re: #anticoagulation & embolic stroke of undetermined so…

Feb 28, 2020 · 1 share · 9,210 followers View post →

JK Han MD

@netta_doc · X

Feb 28, 2020 · 7 likes · 1 share · 8,089 followers View post →

Fernand Bteich, MD, MS

@fernandbteich · X

@ajumathew_ @VPrasadMDMPH https://t.co/BJTlCFVcPW https://t.co/FzleawwFTB

Jun 1, 2019 · 2 likes · 1,904 followers View post →

전기평 Kipyoung Jeon

@Kipyoung_Jeon · X

Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source | NEJM https://t.co/FCwCTCEWW4

May 1, 2019 · 1 like · 40 followers View post →

Pedro Melendez

@drpedro7 · X

RT @Joscast21: La Aspirina aún sigue....⛵ ACO(Rivaroxaban) vs AAS en la recurrencia del ACV Criptogénico (ACVCR)➡igual efecto en la recurre…

Apr 17, 2019 · 2 shares · 524 followers View post →

UTA-BST

@UTA_BST · X

RT @Joscast21: La Aspirina aún sigue....⛵ ACO(Rivaroxaban) vs AAS en la recurrencia del ACV Criptogénico (ACVCR)➡igual efecto en la recurre…

Apr 17, 2019 · 2 shares · 119 followers View post →

José G. Arias Castellanos.

@Joscast21 · X

La Aspirina aún sigue....⛵ ACO(Rivaroxaban) vs AAS en la recurrencia del ACV Criptogénico (ACVCR)➡igual efecto en la recurrencia. Similitud en mortalidad por IM y por todas las causas; pero,⏫3 veces el sangrado mayor y ⏫⏫ 6 veces el ACV Hemorrágico. https://t.co/2ILZHzVET5 https://t.co/zzFH3ZkaIA

Apr 17, 2019 · 2 shares · 134 followers View post →

Pakay

@Pakay20 · X

RT @TJaredBunch: Navigate ESUS is very surprising with no reduction in embolic events w Xarelto (15 mg qd) compared to ASA and no benefit i…

Mar 26, 2019 · 5 shares · 1,597 followers View post →

ニューロドクター乱夢

@hichachu · X

Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source | NEJM https://t.co/FrWeCd1Qng

Mar 18, 2019 · 4,256 followers View post →

Andrew Buelt

@AndrewBuelt · X

#aspirin might not be good for #primaryprevention but stil kind for secondary #Nejm BUT recurrent rates still around 5%! 1 in 20 per year!! #Rivaroxaban #stroke https://t.co/XM5Ex5sewf

Feb 11, 2019 · 872 followers View post →

Dr. Rita McCracken, MD PhD

@ritamc.bsky.social · Bluesky

This is counter to current narrative re: miraculous powers of NOAC's @drjohnm @Drug_Evidence @amtejani Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source | NEJM https://www.nejm.org/doi/10.1056/NEJMoa1802686#.W0K6yOeJnsg.twitter

Jul 8, 2018 View post →