About this trial
This study evaluates the safety and efficacy of early versus delayed initiation of direct oral anticoagulants (DOACs) in patients with acute ischemic stroke related to atrial fibrillation who develop hemorrhagic transformation after endovascular treatment.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Aged 18 years or over.
Clinical diagnosis of large vessel occlusion acute ischemic stroke.
Emergency endovascular treatment was performed within 24 hours of stroke onset.
12-lead ECG recording;
Disqualifiers
Atrial fibrillation due to reversible causes (e.g. thyrotoxicosis, pericarditis, recent surgery, or myocardial infarct).
Known allergy or intolerance to both factor Xa inhibitors and direct thrombin inhibitors;
Definite indication for vitamin K antagonist (VKA) treatment (e.g. mechanical heart valve, valvular atrial fibrillation);
Severe renal impairment (defined as creatinine exceeding 1.5 times of the upper limit of normal range) and significant hepatic dysfunction (defined as ALT or AST > twice the upper limit of normal range) ;
Trial design
Parallel
Treatments tested in this trial
Early anticoagulation
DrugEarly initiation of direct oral anticoagulants will be started within 4 weeks after symptom onset.
Delayed anticoagulation
DrugDelayed initiation of direct oral anticoagulants will be started between 4-8 weeks after symptom onset.
Treatment groups
Trial outcomes
Primary outcomes
Composite outcome of recurrent ischemic stroke, symptomatic intracranial hemorrhage, and all-cause death
Secondary outcomes
Incidence of recurrent ischemic stroke
Incidence of venous thromboembolism
Incidence of systemic embolism
Incidence of myocardial infarction
Other outcomes
Composite outcome of recurrent ischemic stroke, symptomatic intracranial hemorrhage, and all-cause death
Sponsors and contacts
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