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Optimal secondary prevention of embolic stroke of undetermined source (ESUS) is not established. The current standard in these patients is acetylsalicylic acid (ASA), despite high prevalence of yet undetected paroxysmal atrial fibrillation (AF).

ESUS is caused by embolic disease and associated with a high risk of recurrent ischemic strokes and clinically silent cerebral ischemic lesions. The ATTICUS randomized trial will investigate the impact of AF detected by ICM and the effects of early anticoagulation with apixaban compared to antiplatelet therapy with ASA on the incidence of NIL after ESUS.

I’m Carmen Lahiff-Jenkins Managing Editor of the International Journal of Stroke and I spoke to Tobias Geisler, lead author for the Apixaban for treatment of embolic stroke of undetermined source (ATTICUS randomized trial) - Rationale and study design published in the International Journal of Stroke. 

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