Clinical Trial: Dabigatran Following Transient Ischemic Attack and Minor Stroke

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Dabigatran Following Transient Ischemic Attack and Minor Stroke

Brief Summary:

Rationale: To date, anticoagulant therapy in acute stroke has also been limited by excess hemorrhagic events. The oral anticoagulant dabigatran is a novel agent, which has been shown to be associated with much lower intracranial hemorrhage rates. It has been suggested that this agent may provide the superior benefits of anticoagulation in acute stroke, without the concomitant increase in hemorrhage risk associated with heparin/LMWH or warfarin.

Study Design: DATAS II is a randomized, open label blinded endpoint trial. Participants (n=300) with TIA or ischemic stroke (NIHSS score <9) will be enrolled within 48 hours of symptom onset from approximately four (4) health care centres across Canada. All participants will have an MRI with DWI lesion volume < 25 ml. Participants will be randomized 1:1 to treatment with dabigatran for 30 days or ASA 81 mg daily (current standard of care). All stroke patients will initially be screened with a non-contrast CT scan of the brain. The first MRI will be performed within 48 hours of symptom onset. Imaging studies will be repeated at day 30. All patients will be assessed clinically at Day 30 and Day 90.

Study Aims:

  1. Establish the safety of early anticoagulation with the novel oral anticoagulant dabigatran in acute cerebrovascular syndrome patients.
  2. Identify the rate of both symptomatic and asymptomatic hemorrhagic transformation (HT) associated with these treatments.
  3. Identify predictors of HT associated with acute dabigatran treatment.

Hypothesis: The Investigators hypothesize that symptomatic HT rates in dabigatran and ASA treated patients will not be significantly different.

Detailed Summary:
Sponsor: University of Alberta

Current Primary Outcome: Rate of symptomatic hemorrhagic transformation [ Time Frame: within 5 weeks of treatment initiation ]

The primary endpoint is the rate of symptomatic hemorrhagic transformation (HT), defined as a parenchymal hematoma, which is >30% of the infarcted area on DWI, with substantial space-occupying effect, associated with clinical worsening (≥4 point increase in National Institutes of Health Stroke Scale (NIHSS) score) within 5 weeks of treatment initiation.


Original Primary Outcome: Same as current

Current Secondary Outcome: Rate of asymtomatic hemorrhagic transformation [ Time Frame: day 30 ]

Original Secondary Outcome: Same as current

Information By: University of Alberta

Dates:
Date Received: November 17, 2014
Date Started: January 2015
Date Completion:
Last Updated: November 22, 2016
Last Verified: November 2016