Is antiplatelet or anticoagulant therapy preferred for the secondary prophylaxis of cryptogenic stroke in a patient with underlying malignancy?

Will look at the stroke radiographically. If appears embolic and the patient is low risk for bleeding, with respect to their cancer regimen, co-morbidities, and labs, I will discuss off-label anticoagulation with eliquis. If there are additional, chronic embolic appearing strokes - that will also sw...

This really depends on the mechanism of stroke. Given that the question has to do with cryptogenic stroke, the mainstay of therapy is antiplatelet agents. There are no data to suggest that anticoagulant therapy is any better.

There is no clinical trial data about this question of whether to use antiplatelet or anticoagulant therapy with a cryptogenic stroke and an underlying malignancy. I would typically start with antiplatelet therapy and then consider apixaban if there is a recurrent stroke on the initial therapy.

Every stroke patient is different. Will try to guess the best possible explanation for pt stroke, his/her stroke risk factors, cardiac condition, fall risk, involve patient and family in decision making, and then choose between antiplatelets or Apixaban.