Impact of Apixaban on Clinical Outcome of the Patients With Large Vessel Occlusion or Stenosis Trial

NCT02818868 | Completed DMC

• 1 other identifier: 2157
• Study Type: observational
• Target: 700
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to investigate the clinical events of the patients with acute cerebral large vessel occlusion or stenosis and atrial fibrillation, treated by apixaban within 14 days after onset. This is the observational study that patients will be made the registration at the timing of both retrospective period and prospective period.

Conditions

Ischemic Stroke

Outcome Measures

Primary Outcomes (3)

• Death

  90 days after disease onset

• Ischemic events

  90 days after disease onset

• Bleeding events

  90 days after disease onset

Secondary Outcomes (7)

• modified Rankin Scale

  90 days (±10 days) and 365days（±10 days） after disease onset

• Death

  30 days and 365day

• Ischemic event

  30 days and 365day

• Bleeding event

  30 days and 365day

• Significant bleeding (ISTH)

  30 days 90 days (±10 days) and 365day

Interventions

apixisaban DRUG

Also known as: eliquis

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Any adult patient with acute stroke who treated with apixaban.

You may qualify if:

• Patients 20 years and older with acute stroke and treated with oral apixaban within 14 days after onset.
• Patients who are hospitalized in a period from Oct 1, 2014 to Feb 28, 2018
• Patients with acute cerebral large vessel occlusion or stenosis (\> 50%)
• Patients with non-valvular atrial fibrillation
• Patients who are not confirmed ICH by MRI or CT within 24 hours after r-tPA infusion.

You may not qualify if:

• Patients who are considered to be ineligible for the study participation by the investigator.
• Patients who are pregnant or potentially pregnant.
• Patients who have a history of hypersensitivity to apixaban
• Patients with hepatic disease having coagulation disorder and clinically important bleeding risk
• Patients with renal failure (creatinine clearance \< 15 mL/min) 6）Patients with Active pathological bleeding including intracranial bleeding of any type

Sponsors & Collaborators

• Hyogo Medical University: lead

Study Sites (1)

Hyogo collage of Medicine

Nishinomiya, Hyōgo, 665-8501, Japan

Location

Related Publications (21)

• Hirano T, Sasaki M, Mori E, Minematsu K, Nakagawara J, Yamaguchi T; Japan Alteplase Clinical Trial II Group. Residual vessel length on magnetic resonance angiography identifies poor responders to alteplase in acute middle cerebral artery occlusion patients: exploratory analysis of the Japan Alteplase Clinical Trial II. Stroke. 2010 Dec;41(12):2828-33. doi: 10.1161/STROKEAHA.110.594333. Epub 2010 Oct 28.

  PMID: 21030700 RESULT

• Rha JH, Saver JL. The impact of recanalization on ischemic stroke outcome: a meta-analysis. Stroke. 2007 Mar;38(3):967-73. doi: 10.1161/01.STR.0000258112.14918.24. Epub 2007 Feb 1.

  PMID: 17272772 RESULT

• Ogawa A, Mori E, Minematsu K, Taki W, Takahashi A, Nemoto S, Miyamoto S, Sasaki M, Inoue T; MELT Japan Study Group. Randomized trial of intraarterial infusion of urokinase within 6 hours of middle cerebral artery stroke: the middle cerebral artery embolism local fibrinolytic intervention trial (MELT) Japan. Stroke. 2007 Oct;38(10):2633-9. doi: 10.1161/STROKEAHA.107.488551. Epub 2007 Aug 16.

  PMID: 17702958 RESULT

• Lewandowski CA, Frankel M, Tomsick TA, Broderick J, Frey J, Clark W, Starkman S, Grotta J, Spilker J, Khoury J, Brott T. Combined intravenous and intra-arterial r-TPA versus intra-arterial therapy of acute ischemic stroke: Emergency Management of Stroke (EMS) Bridging Trial. Stroke. 1999 Dec;30(12):2598-605. doi: 10.1161/01.str.30.12.2598.

  PMID: 10582984 RESULT

• IMS II Trial Investigators. The Interventional Management of Stroke (IMS) II Study. Stroke. 2007 Jul;38(7):2127-35. doi: 10.1161/STROKEAHA.107.483131. Epub 2007 May 24.

  PMID: 17525387 RESULT

• Cass AS, Cass BP, Veeraraghavan K. Immediate exploration of the unilateral acute scrotum in young male subjects. J Urol. 1980 Dec;124(6):829-32. doi: 10.1016/s0022-5347(17)55687-6.

  PMID: 7441833 RESULT

• Kelly ME, Furlan AJ, Fiorella D. Recanalization of an acute middle cerebral artery occlusion using a self-expanding, reconstrainable, intracranial microstent as a temporary endovascular bypass. Stroke. 2008 Jun;39(6):1770-3. doi: 10.1161/STROKEAHA.107.506212. Epub 2008 Apr 3.

  PMID: 18388338 RESULT

• Mocco J, Hanel RA, Sharma J, Hauck EF, Snyder KV, Natarajan SK, Linfante I, Siddiqui AH, Hopkins LN, Boulos AS, Levy EI. Use of a vascular reconstruction device to salvage acute ischemic occlusions refractory to traditional endovascular recanalization methods. J Neurosurg. 2010 Mar;112(3):557-62. doi: 10.3171/2009.8.JNS09231.

  PMID: 19764826 RESULT

• Flint AC, Duckwiler GR, Budzik RF, Liebeskind DS, Smith WS; MERCI and Multi MERCI Writing Committee. Mechanical thrombectomy of intracranial internal carotid occlusion: pooled results of the MERCI and Multi MERCI Part I trials. Stroke. 2007 Apr;38(4):1274-80. doi: 10.1161/01.STR.0000260187.33864.a7. Epub 2007 Mar 1.

  PMID: 17332445 RESULT

• Penumbra Pivotal Stroke Trial Investigators. The penumbra pivotal stroke trial: safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease. Stroke. 2009 Aug;40(8):2761-8. doi: 10.1161/STROKEAHA.108.544957. Epub 2009 Jul 9.

  PMID: 19590057 RESULT

• Saver JL, Jahan R, Levy EI, Jovin TG, Baxter B, Nogueira RG, Clark W, Budzik R, Zaidat OO; SWIFT Trialists. Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet. 2012 Oct 6;380(9849):1241-9. doi: 10.1016/S0140-6736(12)61384-1. Epub 2012 Aug 26.

  PMID: 22932715 RESULT

• Nogueira RG, Lutsep HL, Gupta R, Jovin TG, Albers GW, Walker GA, Liebeskind DS, Smith WS; TREVO 2 Trialists. Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial. Lancet. 2012 Oct 6;380(9849):1231-40. doi: 10.1016/S0140-6736(12)61299-9. Epub 2012 Aug 26.

  PMID: 22932714 RESULT

• Broderick JP, Palesch YY, Demchuk AM, Yeatts SD, Khatri P, Hill MD, Jauch EC, Jovin TG, Yan B, Silver FL, von Kummer R, Molina CA, Demaerschalk BM, Budzik R, Clark WM, Zaidat OO, Malisch TW, Goyal M, Schonewille WJ, Mazighi M, Engelter ST, Anderson C, Spilker J, Carrozzella J, Ryckborst KJ, Janis LS, Martin RH, Foster LD, Tomsick TA; Interventional Management of Stroke (IMS) III Investigators. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med. 2013 Mar 7;368(10):893-903. doi: 10.1056/NEJMoa1214300. Epub 2013 Feb 7.

  PMID: 23390923 RESULT

• Yoshimura S, Sakai N, Okada Y, Kitagawa K, Kimura K, Tanahashi N, Hyogo T, Yamagami H, Egashira Y; Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism (RESCUE)-Japan Registry Investigators. Efficacy of endovascular treatment for acute cerebral large-vessel occlusion: analysis of nationwide prospective registry. J Stroke Cerebrovasc Dis. 2014 May-Jun;23(5):1183-90. doi: 10.1016/j.jstrokecerebrovasdis.2013.10.014. Epub 2014 Jan 11.

  PMID: 24424332 RESULT

• Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet. 2000 May 13;355(9216):1670-4. doi: 10.1016/s0140-6736(00)02237-6.

  PMID: 10905241 RESULT

• Nezu T, Koga M, Nakagawara J, Shiokawa Y, Yamagami H, Furui E, Kimura K, Hasegawa Y, Okada Y, Okuda S, Kario K, Naganuma M, Maeda K, Minematsu K, Toyoda K. Early ischemic change on CT versus diffusion-weighted imaging for patients with stroke receiving intravenous recombinant tissue-type plasminogen activator therapy: stroke acute management with urgent risk-factor assessment and improvement (SAMURAI) rt-PA registry. Stroke. 2011 Aug;42(8):2196-200. doi: 10.1161/STROKEAHA.111.614404. Epub 2011 Jun 30.

  PMID: 21719764 RESULT

• Mori E, Minematsu K, Nakagawara J, Yamaguchi T, Sasaki M, Hirano T; Japan Alteplase Clinical Trial II Group. Effects of 0.6 mg/kg intravenous alteplase on vascular and clinical outcomes in middle cerebral artery occlusion: Japan Alteplase Clinical Trial II (J-ACT II). Stroke. 2010 Mar;41(3):461-5. doi: 10.1161/STROKEAHA.109.573477. Epub 2010 Jan 14.

  PMID: 20075341 RESULT

• Zaidat OO, Yoo AJ, Khatri P, Tomsick TA, von Kummer R, Saver JL, Marks MP, Prabhakaran S, Kallmes DF, Fitzsimmons BF, Mocco J, Wardlaw JM, Barnwell SL, Jovin TG, Linfante I, Siddiqui AH, Alexander MJ, Hirsch JA, Wintermark M, Albers G, Woo HH, Heck DV, Lev M, Aviv R, Hacke W, Warach S, Broderick J, Derdeyn CP, Furlan A, Nogueira RG, Yavagal DR, Goyal M, Demchuk AM, Bendszus M, Liebeskind DS; Cerebral Angiographic Revascularization Grading (CARG) Collaborators; STIR Revascularization working group; STIR Thrombolysis in Cerebral Infarction (TICI) Task Force. Recommendations on angiographic revascularization grading standards for acute ischemic stroke: a consensus statement. Stroke. 2013 Sep;44(9):2650-63. doi: 10.1161/STROKEAHA.113.001972. Epub 2013 Aug 6. No abstract available.

  PMID: 23920012 RESULT

• Wahlgren N, Ahmed N, Davalos A, Ford GA, Grond M, Hacke W, Hennerici MG, Kaste M, Kuelkens S, Larrue V, Lees KR, Roine RO, Soinne L, Toni D, Vanhooren G; SITS-MOST investigators. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study. Lancet. 2007 Jan 27;369(9558):275-82. doi: 10.1016/S0140-6736(07)60149-4.

  PMID: 17258667 RESULT

• van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988 May;19(5):604-7. doi: 10.1161/01.str.19.5.604.

  PMID: 3363593 RESULT

• Yoshimura S, Uchida K, Sakai N, Imamura H, Yamagami H, Tanaka K, Ezura M, Nonaka T, Matsumoto Y, Shibata M, Ohta H, Morimoto M, Fukawa N, Hatano T, Enomoto Y, Takeuchi M, Ota T, Shimizu F, Kimura N, Kamiya Y, Shimamura N, Morimoto T. Safety of Early Administration of Apixaban on Clinical Outcomes in Patients with Acute Large Vessel Occlusion. Transl Stroke Res. 2021 Apr;12(2):266-274. doi: 10.1007/s12975-020-00839-4. Epub 2020 Aug 7.

  PMID: 32766953 DERIVED

MeSH Terms

Conditions

Ischemic Stroke

Interventions

apixaban

Condition Hierarchy (Ancestors)

Stroke; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor. Department of Neurosurgery

Study Record Dates

• First Submitted: June 7, 2016
• First Posted: June 30, 2016
• Study Start: July 1, 2016
• Primary Completion: February 1, 2018
• Study Completion: February 1, 2018
• Last Updated: January 11, 2022

Record last verified: 2016-11

Data Sharing

• IPD Sharing: Will not share

Locations

JP (1)