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急性虚血性脳卒中を発症した非弁膜症性心房細動患者におけるNOACまたはワルファリン療法中の脳微小出血(CMB-NOW)

基本情報

NCT ID
NCT02356432
ステータス
不明
試験のフェーズ
-
試験タイプ
観察
目標被験者数
86
治験依頼者名
Tokai University

概要

Anticoagulants are generally recognized as a necessary therapy to prevent the recurrence of ischemic stroke in patients with non-valvular atrial fibrillation (NVAF), but in some patients they also cause bleedings, particularly intracranial hemorrhage. One of the independent predictors of intracerebral hemorrhage is the presence of cerebral microbleeds (CMBs); a high incidence of intracerebral hemorrhage is reported in patients with multiple CMBs. Recent study suggested that patients who had CMBs at baseline developed more new CMBs after 2 years (26%), compared with patients (12%) who did not have CMBs at baseline. However, there has been no study on the progression of CMBs in patients receiving so-called novel oral anticoagulants (NOACs). This study tests the hypothesis that the incidence of hemorrhagic stroke is lower in patients receiving NOACs (dabigatran, rivaroxaban, apixaban, and edoxaban) than in those receiving warfarin, and this difference reflects the difference in the effects of warfarin and NOACs on the progression of CMBs. Towards this goal, we enroll 200 patients with at least one CMB detected by 1.5 T MRI (T2\*WI) at baseline, who treated with NOACs or warfarin for 12 months. Primary endpoint is the proportion of subjects with an increased number of CMBs at Month 12 of treatment with NOACs or warfarin. If the results of this study support the efficacy of NOACs in preventing increase of CMBs, this would be of great interest to domestic and overseas clinicians, in view of the potential therapeutic impact, including that for primary prevention of ischemic stroke.

対象疾患

Ischemic StrokeAtrial Fibrillation Symptomatic

依頼者(Sponsor)

実施施設 (4)

聖マリアンナ医科大学病院

Kawasaki, Kanagawa, Japan

Kitasato University Hospital

Sagamihara, Kanagawa, Japan

公立大学法人横浜市立大学附属病院

Yokohama, Kanagawa, Japan

北里大学病院

Sagamihara, Kanagawa, Japan