Study on Anti-Thrombotic Regimens for Secondary Prevention in Ischemic Stroke Patients With Possible Benefit From Anticoagulation Therapy

Inclusion criteria

• Age ≥18 years
• Ischemic stroke patients with undetermined etiology, within 14 days of onset, with completed etiological assessment
• At least one of the following:

• Cortical or multi-territorial infarct
• Recurrent stroke or stroke on antiplatelet therapy
• Left atrial diameter >40 mm
• Left ventricular dysfunction (EF 30-40% or regional wall motion abnormality)
• Atrial premature beats >1500/24h

Exclusion criteria

• Stenosis ≥50% in the responsible vessel or high-risk plaque
• Identified cardioembolic source
• PFO with planned closure
• Malignancy
• Indication for mandatory anticoagulation/antiplatelet therapy
• Active bleeding (intracranial, subarachnoid, gastrointestinal, etc.)
• History of intracranial hemorrhage
• Current or recent gastrointestinal ulcer
• Recent brain or spinal injury/surgery
• Known or suspected vascular malformations or aneurysms
• Severe renal impairment (CrCl <30 ml/min)
• Liver disease with bleeding risk (Child-Pugh B or C)
• Pregnancy or lactation
• Other contraindications to anticoagulation