MidregiOnal Proatrial Natriuretic Peptide to Guide SEcondary Stroke Prevention

Launched by UNIVERSITY OF ZURICH · May 21, 2019

Keywords

ClinConnect Summary

This clinical trial is studying whether a specific group of patients who have had an ischemic stroke (a type of stroke caused by a blockage of blood flow to the brain) can benefit from a new treatment called direct oral anticoagulation (DOAC) within a week after their symptoms start. The researchers are looking at patients who have a certain level of a substance called MRproANP in their blood, which may indicate a higher risk for heart-related problems. The goal is to see if this treatment is more effective than the usual care, which typically involves using antiplatelet drugs to prevent further strokes.

To participate in this trial, patients must be at least 18 years old, have been diagnosed with an ischemic stroke, and have a specific MRproANP level within 72 hours of their stroke. However, individuals with a history of atrial fibrillation (a type of irregular heartbeat), certain other medical conditions, or who are currently pregnant or breastfeeding cannot join. Participants will receive either the new treatment or standard care and will be monitored closely for their health and safety throughout the study. This trial is actively seeking participants, and it offers an opportunity to contribute to important research that could improve stroke care in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Clinical diagnosis of ischemic stroke
• • level ≥200pmol/L within 72 hours from symptom onset
• • Age ≥ 18 years
• • Signed informed consent
• Exclusion Criteria:
• • History of AF, AF on 12-lead ECG on admission or any AF ≥30 seconds during heart-rhythm monitoring prior to randomization
• • Other condition that require anticoagulant therapy (e.g., venous thromboembolism) as per Investigator's judgment including therapeutical dose of low-molecular-weight heparin or heparin
• • Strong likelihood to be treated with prolonged (i.e. more than 30 days) dual antiplatelet therapy during the course of the trial (such as coronary stenting, etc.)
• • Patients undergoing planned procedures where therapy with a DOAC is a contraindication (e.g. surgery)
• • Previous intracranial hemorrhage in the last year
• • Evidence of severe cerebral amyloid angiopathy if MRI scan performed
• • Chronic kidney disease with creatinin clearance \<30ml/min and or subject who requires haemodialysis or peritoneal dialysis
• • Known bleeding diathesis (e.g. active peptic ulcer disease , platelet count \< 100'000/mm3 or haemoglobin \< 9 g/dl or INR ≥ 1.7, documented haemorrhagic tendencies or blood dyscrasias)
• • Active infective endocarditis
• • CT or MRI evidence of cerebral vasculitis
• • Known allergy or intolerance to antiplatelets or DOACs
• • Female who is pregnant or lactating or has a positive pregnancy test at time of admission
• • Current participation in another drug trial