Early Blood-Thinner Timing After Stroke Treatment in People With Atrial Fibrillation
Tests starting a DOAC blood thinner early versus later in people with atrial fibrillation stroke.
Plain-language title generated from the registry record
Registry title: Early Anticoagulation Therapy After Endovascular Treatment for Acute Ischemic Stroke With Atrial Fibrillation
Key facts
- Where
- Shanghai and Suzhou, ChinaSee the 2 sites
Where in China
- Department of Neurology, Huashan Hospital, Fudan UniversityShanghai, ChinaNo longer taking part
- The Fourth Affiliated Hospital of Soochow UniversitySuzhou, ChinaNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- The Fourth Affiliated Hospital of Soochow University
- Trial code
- NCT07849777
- Record updated
- 15 October 2026
- Original description
The goal of this clinical trial is to learn whether starting a direct oral anticoagulant (DOAC) early after endovascular treatment works to improve outcomes in patients with ischemic stroke related to atrial fibrillation. It will also learn about the safety of early DOAC treatment. The main question it aims to answer is:Read full original descriptionShow less
Early Anticoagulation Therapy After Endovascular Treatment for Acute Ischemic Stroke With Atrial Fibrillation
The goal of this clinical trial is to learn whether starting a direct oral anticoagulant (DOAC) early after endovascular treatment works to improve outcomes in patients with ischemic stroke related to atrial fibrillation. It will also learn about the safety of early DOAC treatment. The main question it aims to answer is:
- Does starting DOAC treatment 24 hours after endovascular treatment improve outcomes at 3 months compared with starting it 5 days after randomization?
Researchers will compare early DOAC treatment (started 24 hours after the procedure) with delayed DOAC treatment (started 5 days after randomization) to see if early treatment works better.
Participants will:
* Have atrial fibrillation-related acute ischemic stroke caused by a large vessel blockage in the front part of the brain, within 24 hours of symptom onset * Be randomly assigned to one of two groups after endovascular treatment: early DOAC treatment or delayed DOAC treatment * Take DOACs starting 24 hours after the procedure (early group) or 5 days after randomization (delayed group) * Be followed up for 3 months to check their recovery and any medical problems
Inclusion: Age ≥18 years; Symptom onset within 24 hours before enrollment; A confirmed diagnosis of acute anterior circulation ischemic stroke; A baseline NIHSS score ≥6 at admission; An Alberta Stroke Program Early CT Score (ASPECTS) ≥6; Computed tomography angiography (CTA), magnetic resonance angiography (MRA), or digital subtraction angiography (DSA) confirming occlusion of the intracranial internal carotid artery (ICA) or the M1/M2 segment of the middle cerebral artery (MCA), with the patient scheduled to undergo EVT; Computed tomography (CT) or magnetic resonance imaging (MRI) performed within 24 hours after EVT demonstrating no evidence of hemorrhagic transformation; Documentation of paroxysmal, persistent, or permanent atrial fibrillation based on electrocardiography or previous medical records; Written informed consent provided by the patient or a legally authorized representative.
Exclusion: Concomitant use of azole antifungal agents, HIV protease inhibitors, or strong CYP3A4 inducers; History of major trauma or major surgery within 1 month before stroke onset; Evidence of active bleeding within 1 month before stroke onset, including but not limited to gastrointestinal bleeding or genitourinary bleeding; Participation in another interventional clinical trial within the previous 3 months; Pre-stroke modified Rankin Scale (mRS) score >2; Known hypersensitivity to anticoagulants or any other contraindication to anticoagulant therapy; Any terminal illness with an expected life expectancy of less than 6 months; Any other condition that, in the investigator's judgment, would make the participant unsuitable for the study or interfere with study participation or completion, including but not limited to psychiatric disorders, cognitive or emotional impairment, or physical conditions that preclude adherence to study procedures or follow-up; Presence of systemic bleeding disorders, coagulopathy, or a platelet count <100 × 10⁹/L; Severe hepatic or renal impairment, or receipt of dialysis for any cause. Severe hepatic impairment is defined as alanine aminotransferase (ALT) >3 times the upper limit of normal (ULN) or aspartate aminotransferase (AST) >3× ULN. Severe renal impairment is defined as serum creatinine >3.0 mg/dL (265.2 μmol/L) or an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m²; Valvular atrial fibrillation; Presence of intracranial space-occupying lesions, including intracranial tumors or cerebral vascular malformations; Cerebral amyloid angiopathy; Breastfeeding women.