Early Anticoagulation Therapy After Endovascular Treatment for Acute Ischemic Stroke With Atrial Fibrillation

Ki vehet részt

• 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

Ki nem vehet részt

• 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