NCT02961348

Brief Summary

This study will compare early with late start of treatment with Non-vitamin K oral anticoagulation (NOAC) in adult patients with acute ischemic stroke and atrial fibrillation; it is a registry-based randomized clinical trial (R-RCT) using The Swedish Stroke Register (Riksstroke). Half of the patients will start NOAC early (within 4 days after stroke onset) while the other half will start late (5-10 days after stroke onset).

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
888

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Feb 2017

Longer than P75 for not_applicable

Geographic Reach
1 country

36 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 8, 2016

Completed
2 days until next milestone

First Posted

Study publicly available on registry

November 10, 2016

Completed
3 months until next milestone

Study Start

First participant enrolled

February 15, 2017

Completed
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 10, 2021

Completed
2.9 years until next milestone

Study Completion

Last participant's last visit for all outcomes

April 30, 2024

Completed
Last Updated

May 16, 2024

Status Verified

May 1, 2024

Enrollment Period

4.3 years

First QC Date

November 8, 2016

Last Update Submit

May 15, 2024

Conditions

Keywords

Oral anticoagulants (NOAC)

Outcome Measures

Primary Outcomes (1)

  • Composite outcome of recurrent ischemic stroke, symptomatic intracerebral hemorrhage, or all-cause mortality

    90 days

Secondary Outcomes (5)

  • Recurrent acute ischemic stroke

    90 days

  • Symptomatic intracerebral hemorrhage (S-ICH)

    90 days

  • All-cause mortality

    90 days

  • Functional outcome

    90 days

  • Major hemorrhages

    90 days

Study Arms (2)

Early start of NOAC

ACTIVE COMPARATOR

Day 1 to day 4 after ischemic stroke onset

Other: Early start of NOAC

Late start of NOAC

ACTIVE COMPARATOR

Day 5 to day 10 after ischemic stroke onset

Other: Late start of NOAC

Interventions

Initiation of NOAC up until day 4 after acute ischemic stroke in patients with atrial fibrillation

Early start of NOAC

Initiation of NOAC between day 5 and day 10 after acute ischemic stroke in patients with atrial fibrillation

Late start of NOAC

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult patients (≥ 18 years) with acute ischemic stroke and atrial fibrillation
  • Eligible and willing to start (or re-start) NOAC
  • Registered in The Swedish Stroke Register
  • Signed informed consent

You may not qualify if:

  • Contraindication to NOAC (e.g. ongoing bleeding, mechanical heart valve prosthesis)
  • Ongoing therapy with NOAC (without ≥2 days interruption at index stroke)
  • International normalized ratio (INR)\>1.7
  • No second brain imaging (CT/MRI) after thrombolysis/thrombectomy
  • Previous randomization in the TIMING study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (36)

Alingås Hospital

Alingsås, Sweden

Location

Enköping Hospital

Enköping, Sweden

Location

Mälarsjukhuset Hospital

Eskilstuna, Sweden

Location

Falu Hospital

Falun, Sweden

Location

Gävle Hospital

Gävle, Sweden

Location

Sahlgrenska University Hospital Östra

Gothenburg, Sweden

Location

Sahlgrenska University Hospital

Gothenburg, Sweden

Location

Hallands Hospital

Halmstad, Sweden

Location

Hässleholm Hospital

Hässleholm, Sweden

Location

Helsingborg Hospital

Helsingborg, Sweden

Location

Karolinska University Hospital - Huddinge

Huddinge, Sweden

Location

Hudiksvalls sjukhus

Hudiksvall, Sweden

Location

Ryhov

Jönköping, Sweden

Location

Kalmar Hopsital

Kalmar, Sweden

Location

Länssjukhuset Kalmar

Kalmar, Sweden

Location

Kiruna Hospital

Kiruna, Sweden

Location

Köping Hospital

Köping, Sweden

Location

Kungälv Hospital

Kungälv, Sweden

Location

Lindesberg Hospital

Lindesberg, Sweden

Location

Lund

Lund, Sweden

Location

Malmö University Hospital

Malmo, Sweden

Location

Motala Hospital

Motala, Sweden

Location

Sahlgrenska Universitetssjukhuset Mölndal

Mölndal, Sweden

Location

Nyköping Hospital

Nyköping, Sweden

Location

Oskarshamn Hospital

Oskarshamn, Sweden

Location

Örebro University Hospital

Örebro, Sweden

Location

Skaraborg Hospital

Skövde, Sweden

Location

Karolinska University Hospital

Solna, Sweden

Location

Capio S:t Görans Hospital

Stockholm, Sweden

Location

Danderyd University Hospital

Stockholm, Sweden

Location

Södersjukhuset

Stockholm, Sweden

Location

Sundsvall County Hospital

Sundsvall, Sweden

Location

University Hospital of Umeå

Umeå, Sweden

Location

Uppsala University Hospital

Uppsala, Sweden

Location

Hallands Hospital

Varberg, Sweden

Location

Västerås Hospital

Västerås, Sweden

Location

Related Publications (2)

  • Asberg S, Hijazi Z, Norrving B, Terent A, Ohagen P, Oldgren J. Timing of oral anticoagulant therapy in acute ischemic stroke with atrial fibrillation: study protocol for a registry-based randomised controlled trial. Trials. 2017 Dec 2;18(1):581. doi: 10.1186/s13063-017-2313-9.

    PMID: 29197413BACKGROUND
  • Oldgren J, Asberg S, Hijazi Z, Wester P, Bertilsson M, Norrving B; National TIMING Collaborators. Early Versus Delayed Non-Vitamin K Antagonist Oral Anticoagulant Therapy After Acute Ischemic Stroke in Atrial Fibrillation (TIMING): A Registry-Based Randomized Controlled Noninferiority Study. Circulation. 2022 Oct 4;146(14):1056-1066. doi: 10.1161/CIRCULATIONAHA.122.060666. Epub 2022 Sep 6.

MeSH Terms

Conditions

Ischemic StrokeAtrial Fibrillation

Condition Hierarchy (Ancestors)

StrokeCerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular DiseasesArrhythmias, CardiacHeart DiseasesPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Jonas Oldgren, MD. PhD

    Dept of Medical Sciences, Uppsala University, Sweden

    PRINCIPAL INVESTIGATOR
  • Signild Åsberg, MD. PhD

    Dept of Medical Sciences, Uppsala University, Sweden

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 8, 2016

First Posted

November 10, 2016

Study Start

February 15, 2017

Primary Completion

June 10, 2021

Study Completion

April 30, 2024

Last Updated

May 16, 2024

Record last verified: 2024-05

Data Sharing

IPD Sharing
Will not share

Locations