- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04135677
Clinical Outcomes Between Anticoagulation and DAPT Therapy in AF Patients Successfully Undergoing LAAO
A Multi-center Randomized Controlled Study of High/Low-dosage Rivaroxaban Compared With DAPT After Left Atrial Appendage Occulsion in Patients With Non-valvular Atrial Fibrillation(ESCORT-AF Study(B))
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Transcatheter left atrial appendage occlusion(LAAO) has emerged as an effective alternative for preventing thromboembolic events in patients with nonvalvular atrial fibrillation. The contemporary strategy for post-implantation antithrombotic medication therapy derived from several initial industrialized authoritative researches, demonstrated as 45 days for anticoagulation and prolonged DOAC for 6 months. In spite of the increasing experience of operators and arrival of new technologies, the rates of DRT still maintained. Therefore, whether altered medication therapy post-implantation attracted overwide attention. Nowadays, new oral anticoagulation such as rivaroxaban, dabigatran has evolved empirically and successively has been applied for days-weeks anticoagulation therapy following LAAO ,yet, the specific recommended dosage remained unclear.
Therefore, the objective of the study is to compare the effects of different dosage of rivaroxaban for short-term(12 weeks) anticoagulation therapy versus DAPT for post-LAAO anti-thrombotic therapy.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: XIAOCHUN ZHANG, DR
- Phone Number: 15002121366
- Email: 514864787@qq.com
Study Locations
-
-
Shanghai
-
Shanghai, Shanghai, China, 200032
- Recruiting
- Zhongshan Hospital, Fudan Univerisity
-
Contact:
- XIAOCHUN ZHANG, DR
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Successful transcatheter LAAC using LAMBRE with COST criteria met by intra-procedural TEE and LAA angiography;
- Cha2ds2-Vasc2 score≥2 and or Has-bled score≥3(with contraindication or self-refusal to long-term administration of oral anticoagulants);
- Age18-85 years old;
- Life expectancy≥1 year;
- Written informed consent obtained;
Exclusion Criteria:
- • Prior history of cardiac surgery or with need for intervention in limited intervals;
- Intolerant of TEE or with clinical contraindications for TEE
- Detection of LAA/LA thrombus prior to the procedure;
- Anteroposterior diameter of LAA≥60mm according to TTE
- Impairment of renal function: eGFR≤15ml/min and/or creatinine level≥200μmol/L;
- Patients with hepatic disease that is associated with abnormal blood coagulation(cirrhosis: Child Pugh B an C);
- PLT ≤ 50*10^9/L;
- LVEF≤35% and/or NYHA≥IV;
- Allergies or contraindications to antiplatelet or anticoagulation therapy;
- At high risk of major bleedin(such as gastrointestinal ulcer at present or recently, malignant tumor with high risk of hemorrhage, recent brain or spinal injury, recent brain, spinal or ophthalmic surgery, recent intracranial hemorrhage, known or suspected esophageal varices, arteriovenous malformations, angioaneurysms or major intraspinal or intracerebral vascular malformations, et al)
- Patients with requirement for anticoagulation therapy due to other diseases besides atrial fibrillation (such as after mechanical valve replacement, spontaneous or recurrent venous thromboembolism, etc.);
- Occurrence of severe pericardial tamponade, major hemorrhage and other life-threatening complications after left atrial appendage closure;
- Combined with other basic complications necessary to take drugs that may affect the effect of anticoagulation and antithrombotic regimen in this study(such as pyrrole antifungal agent, human acquired immunodeficiency virus (HIV) protease inhibitor, anti arrhythmia drug dronedarone, powerful cytochrome enzyme CYP3A4 inducer including rifampicin, phenytoin sodium, carbamazepine, phenobarbital, and other anticoagulants).
- Enrolled in other clinical studies in progress;
- Researches think that the patient is not suitable to participate in this study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: TRIPLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: DAPT group
asprin 100mg qd together clopidogrel 75mg for 24 weeks
|
Drug: Aspirin 100mg and clopidogrel 75mg Duration of treatment:24 weeks
Other Names:
|
EXPERIMENTAL: Anticoagulation group
rivaroxaban 20mg qd for for 12 weeks and continued DAPT(asprin 100mg qd together clopidogrel 75mg) for 24 weeks
|
Drug: Rivaroxaban 20mg Duration of treatment: 12 weeks(12 weeks for DAPT afterwards)
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Primacy efficacy endpoint
Time Frame: 24 weeks after LAAC
|
Number of participants with major adverse events(all-cause death, stroke/TIA, systematic embolism)
|
24 weeks after LAAC
|
Primacy safety endpoint
Time Frame: 24 weeks after LAAC
|
Number of participants with bleeding events(major or life-threatening)
|
24 weeks after LAAC
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Device-related thrombosis
Time Frame: at 12-,24-week follow-up
|
Number and rates of participants with DRT on TEE
|
at 12-,24-week follow-up
|
Stroke
Time Frame: at 12,24-week follow-up
|
Rates and distribution of participants withischemic and hemorrhagic stroke
|
at 12,24-week follow-up
|
Bleeding
Time Frame: at 12-,24-week follow-up
|
Number and rates of participants with bleeding events in varying severity
|
at 12-,24-week follow-up
|
Death
Time Frame: at 12-,24-week follow-up
|
Number and rates of cardiovascular-related/not cardiovascular-related death
|
at 12-,24-week follow-up
|
Re-hospitalization
Time Frame: at 12-,24-week follow-up
|
Number and rates of participants indicated for re-hospitalization due to cardiovascular diseases
|
at 12-,24-week follow-up
|
Composed endpoint
Time Frame: at 12-,24-week follow-up
|
Number and rates of composed endpoints(DRT, rehospitalization for cardiovascular diseases and other primary endpoints)
|
at 12-,24-week follow-up
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- DRXCZ
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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