Key result
Early rivaroxaban undergoes testing versus warfarin for recurrent lesions and bleeding in AF-related acute stroke.
Why the study?
Patients with AF in the acute stage of ischemic stroke or TIA are at high risk of recurrent stroke, but the optimal anticoagulation strategy remains unclear due to bleeding concerns.
Does early anticoagulation with rivaroxaban reduce the composite of recurrent ischemic lesion and intracranial bleeding on MRI at four-weeks compared to warfarin in patients with acute ischemic stroke or TIA and nonvalvular atrial fibrillation?
Population
196 acute ischemic stroke or TIA patients with nonvalvular AF and mild to moderate stroke severity
Comparison
Rivaroxaban vs dose-adjusted warfarin with aspirin
Design
Randomized open-label blinded endpoint evaluation trial
Follow-up
Four weeks
Authors
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Will evaluate early rivaroxaban feasibility versus warfarin post-stroke in AF; RCT data needed to guide anticoagulation timing.
RCT (n=196)
Open-label, blinded endpoint evaluation
randomized
Does early anticoagulation with rivaroxaban reduce the composite of recurrent ischemic lesion and intracranial bleeding on MRI at four-weeks compared to warfarin in patients with acute ischemic stroke or TIA and nonvalvular atrial fibrillation?
The Triple AXEL trial is designed to evaluate the feasibility and safety of early anticoagulation with rivaroxaban compared to warfarin in patients with acute ischemic stroke or TIA and nonvalvular atrial fibrillation.
Hong et al. (2014) conducted an RCT in Acute ischemic stroke or TIA with nonvalvular AF (n=196). Rivaroxaban vs. Dose-adjusted warfarin (coadministration of aspirin 100 mg per day until achieving INR of 1.7) was evaluated on Composite of recurrent ischemic lesion and intracranial bleeding on MRI at four-weeks. The Triple AXEL trial is designed to evaluate early anticoagulation with rivaroxaban versus dose-adjusted warfarin in 196 patients with acute ischemic stroke or TIA and nonvalvular AF.
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