What markers of atrial dysfunction are most strongly associated with recurrent stroke risk?
Subgroup analyses of the NAVIGATE ESUS study (Rivaroxaban Versus Aspirin in Secondary Prevention of Stroke and Prevention of Systemic Embolism in Patients With Recent Embolic Stroke of Undetermined Source) suggest that patients with left atrial diameter >4.6 cm may benefit from anticoagulation, while those with PFO did not. Additionally, a post hoc analysis of patients with ESUS enrolled in the SOCRATES trial (Soluble Guanylate Cyclase Stimulator in Heart Failure Studies) did not find an association between ticagrelor treatment and reduced vascular event risk. However, ongoing randomized trials may provide additional information about the efficacy of treatments to prevent recurrent stroke among patients with ESUS.  