Atrial Fibrillation Clinical Trial
Official title:
Recurrent Embolism Lessened by Rivaroxaban, an Anti-Xa Agent of Early Dosing for Acute Ischemic Stroke and Transient Ischemic Attack With Atrial Fibrillation Study (RELAXED)
Early recurrence of cardioembolic stroke in patients with atrial fibrillation is common,
reaching approximately 6% within 30 days after initial stroke. Therefore, it is preferable
to provide early anticoagulation for cardioembolic stroke. However, early anticoagulation
may increase the risk of hemorrhagic transformation of cerebral infarcts. It is difficult to
decide the timing of initiation for anticoagulant therapy in stroke patients with
non-valvular atrial fibrillation (NVAF). In 2013 the European Heart Rhythm Association
presented the practical guides for oral anticoagulants in NVAF patients, which recommend
that the optimal time to start anticoagulant therapy should be determined according to the
stroke severity. However, this recommendation is principally an experts' opinion and is not
suitable in the clinical practice in Japan.
RELAXED, a multicenter observational study is planned to evaluate the efficacy and safety of
an oral direct activated coagulation factor Xa inhibitor, rivaroxaban, for acute ischemic
stroke patients with NVAF in consideration of the infarct size, timing of initiation for
rivaroxaban medication, and other patient characteristics, and thereby to determine the
optimal timing of the initiation during acute ischemic stroke. The consecutive acute
ischemic stroke / transient ischemic attack (TIA) patients with NVAF who are treated with
rivaroxaban will be enrolled. The infarction size at 0-48 hours after stroke onset will be
measured by the diffusion weighted image (DWI) MRI. The primary efficacy endpoint is
recurrent ischemic stroke within 3 months. The primary safety endpoint is major bleedings
within 3 months. The optimal timing to initiate rivaroxaban during acute ischemic stroke is
determined by analysis of co-relation between primary endpoints and the infarct size / time
to initiate rivaroxaban.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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