Apixaban and Clopidogrel for Stroke Prevention in Atrial Fibrillation and Atherosclerosis

This study aims to find the best way to prevent further strokes in people who have both non-valvular atrial fibrillation (NVAF) and atherosclerosis of the brain's blood vessels. NVAF can cause strokes, and atherosclerosis, which is a narrowing of the arteries, adds to the risk. The study focuses on whether using the blood thinner apixaban alone or combined with another drug, clopidogrel, is more effective in preventing strokes in these patients. The results could help establish a more effective treatment plan for those at risk of recurrent strokes due to these combined conditions. Participants in the study will be randomly assigned to receive either apixaban alone or apixaban with clopidogrel for the first 30 days, followed by apixaban alone. The effectiveness of these treatments will be evaluated using MRI scans of the brain to check for new or returning stroke signs after 30 days. Additionally, the study will monitor for any stroke symptoms, heart-related issues, or deaths over a 90-day period. Safety is also a concern, so the study will track any major bleeding events or new brain bleeds that don't show symptoms. All findings will be reviewed by independent experts to ensure accuracy and reliability.