Dabigatran or Aspirin in east asian patients with embolic stroke of undetermined source: RE-SPECT ESUS subgroup analysis

Background and Purpose: We assessed the outcomes of dabigatran versus aspirin in a prespecified subgroup analysis of East Asian patients with embolic stroke of undetermined source in the RE-SPECT ESUS trial (Randomized, Double-Blind, Evaluation in Secondary Stroke Prevention Comparing the Efficacy a...

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Hauptverfasser: Uchiyama, Shinichiro (VerfasserIn) , Toyoda, Kazunori (VerfasserIn) , Lee, Byung-Chul (VerfasserIn) , Liou, Chia-Wei (VerfasserIn) , Wong, Lawrence Ka Sing (VerfasserIn) , Grauer, Claudia (VerfasserIn) , Brückmann, Martina (VerfasserIn) , Taniguchi, Atsushi (VerfasserIn) , Urano, Yasuhisa (VerfasserIn) , Easton, J. Donald (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 16 Feb 2021
In: Stroke
Year: 2021, Jahrgang: 52, Heft: 3, Pages: 1069-1073
ISSN:1524-4628
DOI:10.1161/STROKEAHA.120.031891
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1161/STROKEAHA.120.031891
Verlag, lizenzpflichtig, Volltext: https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.031891
Volltext
Verfasserangaben:Shinichiro Uchiyama, Kazunori Toyoda, Byung-Chul Lee, Chia-Wei Liou, Lawrence Ka Sing Wong, Claudia Grauer, Martina Brueckmann, Atsushi Taniguchi, Yasuhisa Urano, J. Donald Easton, and on behalf of the RE-SPECT ESUS Investigators

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245 1 0 |a Dabigatran or Aspirin in east asian patients with embolic stroke of undetermined source  |b RE-SPECT ESUS subgroup analysis  |c Shinichiro Uchiyama, Kazunori Toyoda, Byung-Chul Lee, Chia-Wei Liou, Lawrence Ka Sing Wong, Claudia Grauer, Martina Brueckmann, Atsushi Taniguchi, Yasuhisa Urano, J. Donald Easton, and on behalf of the RE-SPECT ESUS Investigators 
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520 |a Background and Purpose: We assessed the outcomes of dabigatran versus aspirin in a prespecified subgroup analysis of East Asian patients with embolic stroke of undetermined source in the RE-SPECT ESUS trial (Randomized, Double-Blind, Evaluation in Secondary Stroke Prevention Comparing the Efficacy and Safety of the Oral Thrombin Inhibitor Dabigatran Etexilate Versus Acetylsalicylic Acid in Patients With Embolic Stroke of Undetermined Source). Methods: Patients with a recent embolic stroke of undetermined source were randomized to dabigatran (150 or 110 mg BID) or aspirin (100 mg QD). The primary efficacy outcome was recurrent stroke; the primary safety outcome was major bleeding. The East Asia cohort was compared with patients from all other countries (non-East Asia cohort). Results: Overall, 988 of 5390 patients (18%) were randomized in East Asia. During a median follow-up of 18.8 months, there was no statistically significant difference in recurrent stroke (hazard ratio, 0.65 [95% CI, 0.41-1.03]) or major bleeding (hazard ratio, 1.04 [95% CI, 0.57-1.91]) in East Asian patients receiving dabigatran versus aspirin. Death from any cause occurred more often in the dabigatran versus the aspirin group (hazard ratio, 3.98 [95% CI, 1.32-12.01]). Conclusions: The treatment effect of dabigatran versus aspirin was consistent between cohorts, with no apparent superiority for dabigatran over aspirin in preventing recurrent stroke in patients with embolic stroke of undetermined source. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02239120. 
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