Blinded Randomized Trial of Anticoagulation to Prevent Ischemic Stroke and Neurocognitive Impairment in Atrial Fibrillation (BRAIN-AF): Methods and Design.


Journal

The Canadian journal of cardiology
ISSN: 1916-7075
Titre abrégé: Can J Cardiol
Pays: England
ID NLM: 8510280

Informations de publication

Date de publication:
08 2019
Historique:
received: 18 03 2019
revised: 26 04 2019
accepted: 26 04 2019
entrez: 5 8 2019
pubmed: 5 8 2019
medline: 14 4 2020
Statut: ppublish

Résumé

Compelling evidence showing a link between atrial fibrillation (AF) and cognitive decline and dementia is accumulating. Blinded Randomized Trial of Anticoagulation to Prevent Ischemic Stroke and Neurocognitive Impairment in Atrial Fibrillation (BRAIN-AF) is a prospective, multicentric, double-blind, randomized-controlled trial, recruiting patients with nonvalvular AF and a low risk of stroke. Patients with a high risk of bleeding will be excluded from the study. Participants will be randomized to receive either rivaroxaban (15 mg daily) or standard of care (placebo in patients without vascular disease or acetylsalicylic acid 100 mg daily in patients with vascular disease). The primary outcome is the composite of stroke, transient ischemic attack, and cognitive decline (defined by a decrease in the Montreal Cognitive Assessment score ≥ 3 at any follow-up visit after baseline). Approximately 3250 patients will be enrolled in approximately 130 clinical sites until 609 adjudicated primary outcome events have occurred. BRAIN-AF determines whether oral anticoagulation therapy with rivaroxaban compared with standard of care reduces the risk of stroke, transient ischemic attack, or cognitive decline in patients with nonvalvular AF and a low risk of stroke.

Sections du résumé

BACKGROUND
Compelling evidence showing a link between atrial fibrillation (AF) and cognitive decline and dementia is accumulating.
METHODS
Blinded Randomized Trial of Anticoagulation to Prevent Ischemic Stroke and Neurocognitive Impairment in Atrial Fibrillation (BRAIN-AF) is a prospective, multicentric, double-blind, randomized-controlled trial, recruiting patients with nonvalvular AF and a low risk of stroke. Patients with a high risk of bleeding will be excluded from the study. Participants will be randomized to receive either rivaroxaban (15 mg daily) or standard of care (placebo in patients without vascular disease or acetylsalicylic acid 100 mg daily in patients with vascular disease).
RESULTS
The primary outcome is the composite of stroke, transient ischemic attack, and cognitive decline (defined by a decrease in the Montreal Cognitive Assessment score ≥ 3 at any follow-up visit after baseline). Approximately 3250 patients will be enrolled in approximately 130 clinical sites until 609 adjudicated primary outcome events have occurred.
CONCLUSIONS
BRAIN-AF determines whether oral anticoagulation therapy with rivaroxaban compared with standard of care reduces the risk of stroke, transient ischemic attack, or cognitive decline in patients with nonvalvular AF and a low risk of stroke.

Identifiants

pubmed: 31376908
pii: S0828-282X(19)30295-8
doi: 10.1016/j.cjca.2019.04.022
pii:
doi:

Substances chimiques

Factor Xa Inhibitors 0
Rivaroxaban 9NDF7JZ4M3

Banques de données

ClinicalTrials.gov
['NCT02387229']

Types de publication

Clinical Trial, Phase III Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1069-1077

Informations de copyright

Copyright © 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Auteurs

Lena Rivard (L)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada. Electronic address: lena.rivard@umontreal.ca.

Paul Khairy (P)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Mario Talajic (M)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Jean-Claude Tardif (JC)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Stanley Nattel (S)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Louis Bherer (L)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Sandra Black (S)

Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

Jeffrey Healey (J)

Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.

Sylvain Lanthier (S)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Jason Andrade (J)

University of British Columbia, Vancouver, British Columbia, Canada.

Fadi Massoud (F)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Isabelle Nault (I)

Institut Universitaire de Cardiologie et Pneumologie de Québec, Québec City, Québec, Canada.

Marie-Claude Guertin (MC)

Montreal Health Innovations Coordinating Center, Montréal, Québec, Canada.

Paul Dorian (P)

Terrence Donnelly Heart Centre, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Simon Kouz (S)

Montreal Health Innovations Coordinating Center, Montréal, Québec, Canada.

Vidal Essebag (V)

McGill University Health Centre, Hôpital Sacré Coeur de Montréal, Montréal, Québec, Canada.

Kenneth A Ellenbogen (KA)

Division of Cardiology, Virginia Commonwealth University, Richmond, Virginia, USA.

George Wyse (G)

Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.

Normand Racine (N)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Laurent Macle (L)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Blandine Mondesert (B)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Katia Dyrda (K)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Rafik Tadros (R)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Peter Guerra (P)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Bernard Thibault (B)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Julia Cadrin-Tourigny (J)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Marc Dubuc (M)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Jean-Francois Roux (JF)

Cardiology Service, Department of Medicine, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, Québec, Canada.

Helene Mayrand (H)

Hôpital de la Cité-de-la-Santé, Laval, Québec, Canada.

Isabelle Greiss (I)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

Denis Roy (D)

Department of Medicine, Université de Montréal, Montréal, Québec, Canada.

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