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临床试验/EUCTR2017-000236-34-SK
EUCTR2017-000236-34-SK进行中(未招募)1 期

Early versus Late initiation of direct oral Anticoagulants in post-ischaemic stroke patients with atrial fibrillatioN (ELAN): an international, multicentre, randomised-controlled, two-arm,assessor-blinded trial - ELA

Inselspital (University Hospital) Bern0 个研究点目标入组 2,000 人开始时间: 2020年5月5日最近更新:
适应症
相关药物

试验速览

阶段
1 期
状态
进行中(未招募)
发起方
入组人数
2,000

研究概览

简要总结

暂无简介。

研究设计

研究类型
Interventional clinical trial of medicinal product

入排标准

性别
All

入选标准

  • Written informed consent
  • Age: =18 years
  • Acute ischaemic stroke, either confirmed by MRI or CT scan (tissue based definition) or by sudden focal neurological deficit of presumed ischaemic origin that persisted beyond 24 hours and otherwise normal non-contrast CT scan. Please note: prior intravenous or endovascular treatment is allowed.
  • Permanent, persistent, or paroxysmal spontaneous AF previously known or diagnosed during the index hospitalization
  • Agreement of treating physician to prescribe DOACs
  • Are the trial subjects under 18? no
  • Number of subjects for this age range:
  • F.1.2 Adults (18-64 years) yes
  • F.1.2.1 Number of subjects for this age range 1000
  • F.1.3 Elderly (>=65 years) yes
  • F.1.3.1 Number of subjects for this age range 1000

排除标准

  • Atrial fibrillation due to reversible causes (e.g. thyrotoxicosis, pericarditis, recent surgery, myocardial infarct)
  • Valvular disease requiring surgery
  • Mechanical heart valve(s)
  • Moderate or severe mitral stenosis. Please note that other valvular diseases and biological valves are eligible
  • AF and conditions other than AF that require anticoagulation, including therapeutical dose of low-molecular-weight heparin or heparin.
  • Anticoagulation above the relevant thresholds at ischaemic stroke onset or at hospital admission as follows:
  • o Vitamine K antagonist: International Normalized Ratio (INR) = 1.7, or
  • o Anti-IIa: thrombin time = 80 seconds and/or anti-IIa = 100 ng/ml and/or aPTT value > 1.5x normal, or
  • o Anti-Xa: anti-Xa = 100 ng/ml or = 0.7 U/ml
  • Subject who is contraindicated to DOACs
  • Female who is pregnant or lactating or has a positive pregnancy test at time of admission
  • Patients with serious bleeding in the last 6 months or at high risk of bleeding (e.g. active peptic ulcer disease, platelet count < 100’000/mm3 or haemoglobin < 10 g/dl or INR = 1.7, documented haemorrhagic tendencies or blood dyscrasias)
  • Subject currently uses or has a recent history of illicit drug(s) or abuses alcohol (defined as regular or daily consumption of more than four alcoholic drinks per day)
  • Severe comorbid condition with life expectancy < 6 months
  • Severe renal impairment as described in the summary of medicinal product characteristics for the chosen DOAC (e.g. Rivaroxaban, Apixaban and Edoxaban creatinine clearance <15 ml/min, Dabigatran creatinine clearance <30 ml/min)
  • Subject who requires haemodialysis or peritoneal dialysis
  • Subject with aortic dissection
  • Current participation in another investigational trial
  • Dual antiplatelet therapy (DAPT) at baseline or strong likelihood to be treated with dual antiplatelet therapy during the course of the trial, Please note: transient DAPT is not an exclusion criterion if DAPT is stopped prior to randomisation
  • CT or MRI evidence of haemorrhage classified as PH1 (defined as parenchymal haemorrhage = blood clots in < 30% of the infarcted area without or with slight space-occupying effect) and PH2 (defined as blood clots in > 30% of the infarcted area with a substantial space-occupying effect)42 independently of clinical deterioration. Please note that HI1 (defined as haemorrhagic infarct = small petechiae along the margins of the infarct) and HI2 (defined as confluent petechiae within the infarcted area but no space occupying effect)42 are acceptable if not associated with clinical deterioration and if the treating physician feels comfortable to treat patients with DOACs.
  • CT or MRI evidence of mass effect or intra-cranial tumour (except small meningioma)
  • CT or MRI evidence of cerebral vasculitis
  • Endocarditis
  • Evidence of severe cerebral amyloid angiopathy if MRI scan performed

研究者

发起方
Inselspital (University Hospital) Bern

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