Early Rivaroxaban for Acute Ischemic Stroke or TIA Patients With Atrial Fibrillation

Phase 4

Recruiting

• Conditions: Cerebral Infarction; TIA
• Interventions: Drug: Rivaroxaban

• Registration Number: NCT03749057
• Lead Sponsor: General Hospital of Shenyang Military Region

Brief Summary

Anticoagulant treatment for non-valvular atrial fibrillation (AF) associated with cerebral infarction/ TIA is one of the recognized treatment of stroke prevention. The ACC/AHA and national guidelines for the management of anticoagulation recommend that most of AF patients with cerebral infarction or TIA should be administrated anticoagulant therapy within 14 days of symptom onset, while European guidelines recommend that the timing of the initiation of non-vitamin K antagonist oral anticoagulants (NOACs) for AF patients with cerebral infarction or TIA is association with stroke severity in light of the "1-3-6-12" principle. However, there are still many problems about the use of NOACs in ischemic stroke with AF. for example, it is unclear what time to begin NOACs as to difference in stroke severity, ages, comorbidity with hypertension, diabetes, heart failure, liver and kidney dysfunction and bleeding risks. Thus, the timing of the initiation of NOACs is yet to be further studied. Current urgent need is to develop a guideline-based specific regimen in which the benefit-risk factors are further balanced with a combination of NHISS, CHA2DS2-VASC and HAS-BLED score.

Rivaroxaban, a direct coagulation factor Ⅹa inhibitor, blocks the formation of the clot. ROCKET-AF study has shown that the efficacy of rivaroxaban is not inferior to that of warfarin in AF patients on stroke prevention, and rivaroxaban has a significantly decreased bleeding risk compared with warfarin. Recent study indicates that early administration with rivaroxaban for AF patients within 14 days of onset does not significantly increase hemorrhagic transformation. However, the relevant clinical data of the efficacy and safety of early initiation of rivaroxaban in AF patients with cerebral infarction or TIA are lacking in China.

Therefore, the investigators conduct a multicenter cohort study to investigate the safety of early rivaroxaban in the AF patient with cerebral infarction or TIA within 12 days of onset.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2018-11-16
• Study First Submitted QC: 2018-11-19
• Study Start: 2018-11-20
• Study First Posted: 2018-11-21
• Status Verified: 2023-12
• Last Update Submitted: 2023-12-30
• Last Update Posted: 2024-01-03
• Primary Completion: 2024-06-30
• Study Completion: 2024-06-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 400

Inclusion Criteria

Not provided

Exclusion Criteria

1. Hemorrhagic stroke or mixed stroke
2. Patients with valvular atrial fibrillation or non-cardiogenic cerebral infarction
3. Patients with severe infection or serious diseases
4. Gastrointestinal bleeding or major operation within 3 months
5. Planed cerebrovascular reconstruction or cardiac surgery within 3 months
6. Planed major surgery within 3 months
7. Participating in other clinical trials within 3 months
8. Unsuitable for this trial assessed by research

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
rivaroxaban	Rivaroxaban	15-20 mg rivaroxaban daily

Primary Outcome Measures

Name	Time	Method
incidence of intracranial hemorrhage	7 days

Secondary Outcome Measures

Name	Time	Method
recurrence of stroke or other vascular events	90 days
bleeding event	90 days	Any bleeding event except intracranial hemorrhage
incidence of early neurological deterioration	7 days	2 or more increase in NIHSS
Serious adverse events	90 days

Trial Locations

Locations (1)

General Hospital of ShenYang Military Region; 🇨🇳 Shenyang, China