MRI Findings of Intracranial Hemorrhages in ARCADIA-MRI: An Ancillary Study to the ARCADIA Trial
Bibliographic record
Abstract
ABSTRACT BACKGROUND AND PURPOSE: The ARCADIA-MRI study, an ancillary study to the randomized Atrial Cardiopathy and Antithrombotic Drugs in Prevention After Cryptogenic Stroke (ARCADIA) trial, reported that the risk of incident non-lacunar covert infarcts was lower in the apixaban group than the aspirin group. This paper presents the additional, prespecified, exploratory outcomes beyond the primary paper, specifically examining the effect of apixaban on hemorrhagic lesions on MRI. MATERIALS AND METHODS: The ARCADIA-MRI study was conducted in conjunction with ARCADIA trial visits, with follow-up durations ranging from 4 months to 5.3 years (median 27 months). It included randomized patients who were eligible for cognitive testing and lacked MRI contraindications. Two experienced raters, blinded to treatment assignments, independently evaluated the baseline and follow-up MRI scans. The radiological endpoints of this analysis were incident intracerebral hemorrhages (>10 mm), microbleeds (≤10 mm), and superficial siderosis. RESULTS: MRI outcomes were compared between the 79 patients in the apixaban group and 95 in the aspirin group with both baseline and follow-up MRIs available. The treatment groups had similar baseline MRI findings. On the follow-up MRIs, the findings of incident bleeding events were all similar between the treatment groups (all p > 0.05): intracerebral hemorrhages occurred in 5.1% of patients in the apixaban group compared to 6.4% of patients in the aspirin group; microbleeds, 7.8% in the apixaban group and 10.8% in the aspirin group; and cortical superficial siderosis, in 7.7% of apixaban group and 12.9% in the aspirin group. CONCLUSIONS: In an exploratory analysis of the ARCADIA-MRI substudy, MRI findings of incident bleeding events were similar in patients randomized to receive apixaban and aspirin. ABBREVIATIONS: ARCADIA= atrial cardiopathy and antithrombotic drugs in prevention after cryptogenic stroke; AF= atrial fibrillation; DOAC= direct-acting oral anticoagulants; ICH =intracerebral hemorrhage; NT-proBNP= N-terminal pro–B-type natriuretic peptide; NAVIGATE ESUS=Rivaroxaban versus aspirin for prevention of covert brain infarcts in patients with embolic stroke of undetermined source; RE-SPECT ESUS=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; COMPASS =Cardiovascular Outcomes for People Using Anticoagulation Strategies; ATTICUS study =The Apixaban for Treatment of Embolic Stroke of Undetermined Source.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".