Apixaban to Prevent Recurrence After Cryptogenic Stroke—Reply

In Reply In response to our recent article, Dr Chi and colleagues raise an important point regarding uncertainty about optimal biomarkers of atrial cardiopathy. Compared with ARCADIA patients who qualified for enrollment in our study only by the NT-proBNP criterion, those who qualified by only the electrocardiographic criterion had significantly younger mean age (64.1 vs 71.1 years), higher mean weight (87.0 vs 83.9 kg), and a lower mean CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [doubled], diabetes, stroke/transient ischemic attack/thromboembolism [doubled], vascular disease [prior myocardial infarction, peripheral artery disease, or aortic plaque], age 65-75 years, sex category [female]) score (4.2 vs 5.1); were more often male (53.1% vs 38.4%) and Black or African American (29.4% vs 12.7%); and had a lower prevalence of ischemic heart disease (6.7% vs 11.9%), heart failure (3.9% vs 8.9%), diabetes (27.8% vs 35.9%), and hypertension (70.9% vs 79.5%). Only 4 patients qualified for study enrollment by only echocardiographic criterion, which precludes meaningful comparisons. We found no significant evidence that the effect of treatment varied based on which biomarker led to trial inclusion.