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New Oral Anticoagulants (NOAC) in Stroke Patients

Completed
Conditions
Stroke
Atrial Fibrillation
Interventions
Other: treatment with NOACs or VKAs
Registration Number
NCT03826927
Lead Sponsor
University Hospital, Basel, Switzerland
Brief Summary

Registry to explore characteristics, use and management of new oral anticoagulants (NOAC) and vitamin K antagonists (VKA) treatment among patients with atrial fibrillation (AF) and recent cerebrovascular disease in a "real-world" setting at a stroke centre.

Detailed Description

Registry to explore characteristics, use and management of new oral anticoagulants (NOAC) and vitamin K antagonists (VKA) treatment among patients with atrial fibrillation (AF) and recent cerebrovascular disease in a "real-world" setting at a stroke centre. Special interest is payed to conditions not or only in part investigated in the large randomised controlled Trials (RCT) and that are specific to patients with cerebrovascular disease. This includes early start of NOAC treatment after recent stroke, very old patients, multimorbidity, patients with a history of intracranial haemorrhage (ICH) and patient satisfaction and preferences with VKA/NOACS.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1023
Inclusion Criteria
  • signed informed consent form (ICF)
  • existing or newly diagnosed AF
  • recent (< 3 month) stroke (ischemic or haemorrhagic) or TIA (=index event)
  • treatment with NOACs or VKAs is continued, changed or initiated for prevention of ischemic events
Exclusion Criteria
  • patients not able or unwilling to sign ICF
  • patient is, in the opinion of the investigator, unlikely to comply with the scheduled follow-up visits or is unsuitable for any other reason
  • patients who will not be anticoagulated

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
AF and cerebrovascular eventtreatment with NOACs or VKAspatients with AF and recent (\< 3 month) stroke or transient ischaemic attack (TIA) or intracranial haemorrhage (ICH) with or without pre-existing oral anticoagulation, in whom treatment with NOACs or VKAs is initiated or continued for prevention of ischemic events
Primary Outcome Measures
NameTimeMethod
Change in anticoagulation (NOAC and VKA) treatmenttime from index event (= cerebrovascular event) to Follow- up assessments at 3-, 6-, 12- and 24 months after index event

assessment of details of NOAC or VKA application (start, pause, dosage)

Secondary Outcome Measures
NameTimeMethod
Co-morbiditiestime from index event (= cerebrovascular event) to Follow- up assessments at 3-, 6-, 12- and 24 months after index event

Recording of co-morbidities

Change in anticoagulant treatmenttime from index event (= cerebrovascular event) to Follow- up assessments at 3-, 6-, 12- and 24 months after index event

If anticoagulant treatment was stopped or switched to any other drug (NOAC/VKA), reason for switching will be documented

Change in modified Rankin Scale (mRS)time from index event (= cerebrovascular event) to Follow- up assessments at 3-, 6-, 12- and 24 months after index event

modified Rankin Scale (mRS) is a scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability; scale runs from 0-6, running from perfect health (=0) without symptoms to death (=6)

Change in glomerular filtration rate (GFR)time from index event (= cerebrovascular event) to Follow- up assessments at 3-, 6-, 12- and 24 months after index event

impact of kidney function (in particular volatile GFR (ml/min) around the threshold for reduced dosage)

Drug adherence for anticoagulation (VKA) treatmenttime from index event (= cerebrovascular event) to Follow- up assessments at 3-, 6-, 12- and 24 months after index event

monitor the frequency of VKA use in patients with stroke or TIA attributable to AF, (a) among patients without pre-existing anticoagulation, (b) among patients under insufficient VKA therapy, and (c) among patients with sufficient VKA therapy, assessed by telephone or clinical visit

Drug adherence for anticoagulation (NOAC) treatmenttime from index event (= cerebrovascular event) to Follow- up assessments at 3-, 6-, 12- and 24 months after index event

monitor the frequency of NOAC use in patients with stroke or TIA attributable to AF, assessed by telephone or clinical visit

Recording of Adverse Events (AE)time from index event (= cerebrovascular event) to Follow- up assessments at 3-, 6-, 12- and 24 months after index event

Causality for AE will be assessed as related, possibly related or non-related to the prescribed anticoagulant

Trial Locations

Locations (2)

Felix Platter Spital

🇨🇭

Basel, Switzerland

Dep. of Neurology, Hospital of the University of Basel

🇨🇭

Basel, Switzerland

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