RecruitingPhase 3NCT03907046

Anticoagulation in ICH Survivors for Stroke Prevention and Recovery

Anticoagulation in Intracerebral Hemorrhage (ICH) Survivors for Stroke Prevention and Recovery


Sponsor

Yale University

Enrollment

700 participants

Start Date

Jan 28, 2020

Study Type

INTERVENTIONAL

Conditions

Summary

Primary Aim: To determine if apixaban is superior to aspirin for prevention of the composite outcome of any stroke (hemorrhagic or ischemic) or death from any cause in patients with recent ICH and atrial fibrillation (AF). Secondary Aim: To determine if apixaban, compared with aspirin, results in better functional outcomes as measured by the modified Rankin Scale.


Eligibility

Min Age: 18 Years

Inclusion Criteria6

  • Age at least 18 years
  • Intracerebral hemorrhage (ICH) (including primary intraventricular hemorrhage) confirmed by brain CT or MRI
  • Can be randomized within 14-180 days after ICH onset
  • Non-valvular AF (defined as atrial fibrillation or atrial flutter), documented by electrocardiography or a physician-confirmed history of prior AF
  • Provision of signed and dated informed consent form by patient or legally authorized representative
  • For females of reproductive potential: use of highly effective contraception

Exclusion Criteria15

  • Index event is hemorrhagic transformation of a brain infarction or hemorrhage into a tumor
  • History of earlier ICH within 12 months preceding index event
  • Active infective endocarditis
  • Clear indication for anticoagulant drugs (e.g., requires anticoagulation for deep vein thrombosis or pulmonary embolism) or antiplatelet drugs (e.g., requires aspirin or clopidogrel for recent coronary stent).
  • Previous or planned left atrial appendage closure
  • Clinically significant bleeding diathesis
  • Serum creatinine ≥2.5 mg/dL
  • Active hepatitis or hepatic insufficiency with Child-Pugh score B or C
  • Anemia (hemoglobin \<8 g/dL) or thrombocytopenia (\<100 x 10\^9/L) that is chronic in the judgment of the investigator
  • Pregnant or breastfeeding
  • Known allergy to aspirin or apixaban
  • Concomitant participation in a competing trial
  • Considered by the investigator to have a condition that precludes safe or active participation in the trial
  • Persistent, uncontrolled systolic blood pressure (≥180 mm Hg)
  • ICH caused by an arteriovenous malformation (AVM) that has not yet been secured

Interventions

DRUGApixaban

Apixaban is an oral anticoagulant of the Factor Xa inhibitor class.

DRUGAspirin

Aspirin is an oral antiplatelet drug.


Locations(184)

University of Alabama Hospital

Birmingham, Alabama, United States

University of South Alabama University Hospital

Mobile, Alabama, United States

Chandler Regional Medical Center

Chandler, Arizona, United States

St. Joseph's Hospital and Medical Center

Phoenix, Arizona, United States

Banner University Medical Center

Tucson, Arizona, United States

UAMS Medical Center

Little Rock, Arkansas, United States

Mercy San Juan Medical Center

Carmichael, California, United States

Eden Medical Center, Castro Valley

Castro Valley, California, United States

Arrowhead Regional Medical Center

Colton, California, United States

Rancho Los Amigos National Rehabilitation Center

Downey, California, United States

Kaiser Permanente Fontana Medical Center

Fontana, California, United States

Community Regional Medical Center of Fresno

Fresno, California, United States

St. Jude Medical Center

Fullerton, California, United States

Long Beach Memorial Medical Center

Long Beach, California, United States

Los Alamitos Medical Center

Los Alamitos, California, United States

Kaiser Permanente Los Angeles Medical Center

Los Angeles, California, United States

Cedars-Sinai Medical Center

Los Angeles, California, United States

Ronald Reagan UCLA Medical Center

Los Angeles, California, United States

Doctors Medical Center Modesto, Modesto, CA

Modesto, California, United States

Hoag Hospital Newport Beach

Newport Beach, California, United States

UC Irvine Medical Center

Orange, California, United States

Desert Regional Medical Center

Palm Springs, California, United States

Huntington Memorial Hospital

Pasadena, California, United States

Kaiser Permanente Redwood City Medical Center, Redwood City, CA

Redwood City, California, United States

UC Davis Medical Center

Sacramento, California, United States

Kaiser Permanente Sacramento Medical Center

Sacramento, California, United States

San Francisco General Hospital

San Francisco, California, United States

Santa Barbara Cottage Hospital

Santa Barbara, California, United States

Stanford University Medical Center

Stanford, California, United States

PIH Health Hospital - Whittier

Whittier, California, United States

University of Colorado Hospital

Aurora, Colorado, United States

St. Mary's Medical Center

Grand Junction, Colorado, United States

Danbury Hospital

Danbury, Connecticut, United States

Hartford Hospital

Hartford, Connecticut, United States

Yale New Haven Hospital

New Haven, Connecticut, United States

New Hanover Regional Medical Center

Wilmington, Delaware, United States

MedStar Georgetown University Hospital

Washington D.C., District of Columbia, United States

MedStar Washington Hospital Center

Washington D.C., District of Columbia, United States

George Washington University Hospital

Washington D.C., District of Columbia, United States

Morton Plant Hospital

Clearwater, Florida, United States

Broward Health Medical Center

Fort Lauderdale, Florida, United States

UF Health Jacksonville

Jacksonville, Florida, United States

Mayo Clinic

Jacksonville, Florida, United States

Jackson Memorial Hospital

Miami, Florida, United States

Ascension Sacred Heart Pensacola

Pensacola, Florida, United States

Cleveland Clinic Tradition Hospital

Port Saint Lucie, Florida, United States

Tampa General Hospital

Tampa, Florida, United States

St. Joseph's Hospital

Tampa, Florida, United States

Grady Memorial Hospital

Atlanta, Georgia, United States

Emory University Hospital

Atlanta, Georgia, United States

Augusta University Medical Center

Augusta, Georgia, United States

WellStar Kennestone Hospital

Marietta, Georgia, United States

The Queen's Medical Center

Honolulu, Hawaii, United States

Saint Alphonsus Regional Medical Center - Boise

Boise, Idaho, United States

NCH Hospital, Arlington Heights

Arlington Heights, Illinois, United States

Rush University Medical Center

Chicago, Illinois, United States

University of Illinois Hospital

Chicago, Illinois, United States

University of Chicago Medical Center

Chicago, Illinois, United States

Evanston Hospital

Evanston, Illinois, United States

Loyola University Medical Center

Maywood, Illinois, United States

OSF St. Francis Medical Center

Peoria, Illinois, United States

Javon Bea Hospital - Riverside

Rockford, Illinois, United States

St. John's Hospital

Springfield, Illinois, United States

Central DuPage Hospital

Winfield, Illinois, United States

IU Health Methodist Hospital

Indianapolis, Indiana, United States

University of Iowa Medical Center

Iowa City, Iowa, United States

University of Kansas Hospital

Kansas City, Kansas, United States

Baptist Health Lexington

Lexington, Kentucky, United States

University of Kentucky Hospital

Lexington, Kentucky, United States

University of Louisville Hospital

Louisville, Kentucky, United States

Ochsner Medical Center - Main Campus

New Orleans, Louisiana, United States

Eastern Maine Medical Center

Bangor, Maine, United States

Maine Medical Center

Portland, Maine, United States

Tufts Medical Center

Boston, Massachusetts, United States

Massachusetts General Hospital

Boston, Massachusetts, United States

Boston Medical Center

Boston, Massachusetts, United States

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Lahey Hospital & Medical Center

Burlington, Massachusetts, United States

Baystate Medical Center

Springfield, Massachusetts, United States

UMass Memorial Medical Center

Worcester, Massachusetts, United States

University of Michigan University Hospital

Ann Arbor, Michigan, United States

Henry Ford Hospital

Detroit, Michigan, United States

McLaren Flint

Flint, Michigan, United States

Trinity Health Saint Mary's

Grand Rapids, Michigan, United States

Trinity Health Saint Mary's

Grand Rapids, Michigan, United States

McLaren Macomb

Mount Clemens, Michigan, United States

Munson Medical Center

Traverse City, Michigan, United States

Metro Health Hospital

Wyoming, Michigan, United States

Abbott Northwestern Hospital

Minneapolis, Minnesota, United States

M Health Fairview University of Minnesota Medical Center

Minneapolis, Minnesota, United States

St. Cloud Hospital

Saint Cloud, Minnesota, United States

HealthPartners Methodist Hospital

Saint Louis Park, Minnesota, United States

Regions Hospital

Saint Paul, Minnesota, United States

United Hospital, St. Paul

Saint Paul, Minnesota, United States

University of Mississippi Medical Center

Jackson, Mississippi, United States

University of Missouri Health Care

Columbia, Missouri, United States

Mercy Hospital Springfield

Springfield, Missouri, United States

Cox Medical Center South

Springfield, Missouri, United States

Barnes Jewish Hospital

St Louis, Missouri, United States

Mercy Hospital South

St Louis, Missouri, United States

Mercy Hospital St. Louis

St Louis, Missouri, United States

University of Nebraska Medical Center

Omaha, Nebraska, United States

Hackensack University Medical Center

Hackensack, New Jersey, United States

Cooperman Barnabas Medical Center

Livingston, New Jersey, United States

Overlook Medical Center

Summit, New Jersey, United States

Capital Health Regional Medical Center

Trenton, New Jersey, United States

University of New Mexico Hospital

Albuquerque, New Mexico, United States

Kings County Hospital Center

Brooklyn, New York, United States

NewYork-Presbyterian Brooklyn Methodist Hospital

Brooklyn, New York, United States

Maimonides Medical Center

Brooklyn, New York, United States

NYU Langone Hospital - Brooklyn

Brooklyn, New York, United States

Buffalo General Medical Center

Buffalo, New York, United States

NYC Health + Hospitals/Elmhurst

Elmhurst, New York, United States

North Shore University Hospital

Manhasset, New York, United States

Mount Sinai West

New York, New York, United States

The Mount Sinai Hospital

New York, New York, United States

NYP Columbia University Medical Center

New York, New York, United States

NYP Weill Cornell Medical Center

New York, New York, United States

Vassar Brothers Medical Center

Poughkeepsie, New York, United States

Strong Memorial Hospital

Rochester, New York, United States

Staten Island University Hospital - North Campus

Staten Island, New York, United States

Stony Brook University Hospital

Stony Brook, New York, United States

SUNY Upstate Medical University

Syracuse, New York, United States

Montefiore Medical Center

The Bronx, New York, United States

Westchester Medical Center

Valhalla, New York, United States

Burke Rehabilitation Center

White Plains, New York, United States

University of North Carolina Medical Center

Chapel Hill, North Carolina, United States

Carolinas Medical Center

Charlotte, North Carolina, United States

Presbyterian Medical Center

Charlotte, North Carolina, United States

Duke University Hospital

Durham, North Carolina, United States

Moses H. Cone Memorial Hospital

Greensboro, North Carolina, United States

ECU Health Medical Center

Greenville, North Carolina, United States

New Hanover Regional Medical Center

Wilmington, North Carolina, United States

Forsyth Medical Center

Winston-Salem, North Carolina, United States

Wake Forest Baptist Medical Center

Winston-Salem, North Carolina, United States

Cleveland Clinic Akron General

Akron, Ohio, United States

University of Cincinnati Medical Center

Cincinnati, Ohio, United States

Good Samaritan Hospital

Cincinnati, Ohio, United States

UH Cleveland Medical Center

Cleveland, Ohio, United States

MetroHealth Medical Center

Cleveland, Ohio, United States

Cleveland Clinic

Cleveland, Ohio, United States

OSU Wexner Medical Center

Columbus, Ohio, United States

Riverside Methodist Hospital

Columbus, Ohio, United States

OU Medical Center

Oklahoma City, Oklahoma, United States

Mercy Hospital Oklahoma City

Oklahoma City, Oklahoma, United States

Ascension St. John Medical Center

Tulsa, Oklahoma, United States

St. John Medical Center

Tulsa, Oklahoma, United States

Oregon Health & Science University Hospital

Portland, Oregon, United States

Providence St. Vincent Medical Center

Portland, Oregon, United States

PeaceHealth Sacred Heart Medical Center - RiverBend

Springfield, Oregon, United States

Jefferson Abington Hospital

Abington, Pennsylvania, United States

Lehigh Valley Hospital - Cedar Crest

Allentown, Pennsylvania, United States

Geisinger Medical Center

Danville, Pennsylvania, United States

Penn State Hershey Medical Center

Hershey, Pennsylvania, United States

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, United States

Temple University Hospital

Philadelphia, Pennsylvania, United States

UPMC Presbyterian Hospital

Pittsburgh, Pennsylvania, United States

Rhode Island Hospital

Providence, Rhode Island, United States

Medical University of South Carolina University Hospital

Charleston, South Carolina, United States

Greenville Hospital System

Greenville, South Carolina, United States

Avera Research Institute

Sioux Falls, South Dakota, United States

Erlanger Health System

Chattanooga, Tennessee, United States

Fort Sanders Regional Medical Center

Knoxville, Tennessee, United States

Methodist University Hospital

Memphis, Tennessee, United States

Semmes Murphey Main Campus

Memphis, Tennessee, United States

Vanderbilt University Hospital

Nashville, Tennessee, United States

St. David's Medical Center

Austin, Texas, United States

UT Southwestern Medical Center

Dallas, Texas, United States

Baylor College of Medicine Medical Center

Houston, Texas, United States

Houston Methodist Hospital

Houston, Texas, United States

Memorial Hermann Texas Medical Center

Houston, Texas, United States

University of Texas Health Science Center San Antonio

San Antonio, Texas, United States

University of Utah Healthcare

Salt Lake City, Utah, United States

The University of Vermont Medical Center

Burlington, Vermont, United States

UVA Medical Center

Charlottesville, Virginia, United States

Inova Fairfax Hospital

Falls Church, Virginia, United States

Bon Secours St. Mary's Hospital

Richmond, Virginia, United States

VCU Medical Center

Richmond, Virginia, United States

Virginia Mason Medical Center

Seattle, Washington, United States

Harborview Medical Center

Seattle, Washington, United States

Swedish Medical Center - Cherry Hill Campus

Seattle, Washington, United States

WVU Healthcare Ruby Memorial Hospital

Morgantown, West Virginia, United States

Froedtert Hospital

Milwaukee, Wisconsin, United States

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