Advancing Knowledge in Ischemic Stroke Patients on Oral Anticoagulants

NCT ID: NCT06823466

Last Updated: 2025-02-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-02-12

Study Completion Date

2031-02-12

Brief Summary

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The Advancing knowledge in ischemic Stroke PatiEnts on oRal Anticoagulants (ASPERA) study aims to investigate characteristics of ischemic stroke cases occurring in patients on oral anticoagulation for atrial fibrillation (AF) or other cardioembolic arrhythmias and to characterize short and long-term outcomes associated with different secondary prevention strategies to prevent stroke recurrences. The ASPERA study is a multicenter, observational, both retrospective and prospective real-world study involving acute ischemic stroke patients occurring on oral anticoagulation. The study will encompass a retrospective (ASPERA-R) and prospective (ASPERA-P) data collection. Patient will be recruited consecutively at different emergency services and stroke units worldwide. University of L'Aquila (UnivAQ) will be in charge of study coordination, data analysis and management. The duration of ASPERA-R will be of 5-year from the study initiation of the study. Participating centers will be given a 6-month timeframe to enter retrospective data, commencing from the date of study approval.

ASPERA-P duration will be of 2 years of enrollment from the study approval and follow-up of 5 years. (study conclusion after 7 years of approval). Inclusion criteria will be: 1.Confirmed diagnosis of ischemic stroke. 2. Availability of at least one neuroimaging exam positive for ischemic lesion(s) consistent with patient symptoms. 3. Ongoing oral anticoagulation at the time of the index ischemic stroke. 4. Prior diagnosis of atrial fibrillation or other cardioembolic arrhythmias. 5. Written informed consent provided by the patient himself or by proxy. Patients with Symptoms not indicative of acute stroke, ongoing intravenous or subcutaneous anticoagulation at the time of stroke will be excluded. ASPERA-R: characterization of demographic, clinical and neuroimaging features of ischemic stroke cases occurring on oral anticoagulants. The primary outcome will be: ASPERA-R : characterization of demographic, clinical and neuroimaging features of ischemic stroke cases occurring on oral anticoagulants. ASPERA-P: risk of ischemic stroke recurrence of ischemic stroke cases occurring on oral anticoagulants across different secondary preventive strategies (i.e., maintaining the same type of oral anticoagulation versus switching to a different secondary prevention strategy) at 90 days, 1 and 5 years after the index stroke. Additionally, the study will aim to investigate the risk of safety events (hemorrhagic transformation, intracranial hemorrhage, other major bleeding events, any bleeding events, death due to any cause), risk of other major ischemic events (transient ischemic attack, myocardial infarction, death due to vascular causes) at each follow-up and to identify demographic, clinical and neuroimaging features of ischemic stroke recurrences.

Detailed Description

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Conditions

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Ischemic Stroke Oral Anticoagulation Atrial Fibrillation (AF) Outcome Assessment Clinical Presentations

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Study Groups

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ASPERA-R

Retrospectively enrolled schemic stroke patients on oral anticoagulants at the time of the index stroke followed up at hospital discharge and 90 days post-stroke

No interventions assigned to this group

ASPERA-P

Prospectively enrolled ischemic stroke patients on oral anticoagulants at the time of the index stroke followed up at 90 days, 1 year and 5 years post-stroke

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years at the time of the index ischemic stroke.
* Confirmed diagnosis of ischemic stroke according to the World Health Organization (WHO) definition.
* Availability of at least one neuroimaging exam (either a non-contrast computed tomography \[NCCT\] or magnetic resonance imaging \[MRI\] of the brain) demonstrating one or more ischemic lesions consistent with patient symptoms.
* Ongoing oral anticoagulation at the time of the index ischemic stroke, defined as the last intake within 48 hours prior to stroke symptom onset for patients on direct oral anticoagulants (DOACs), or an international normalized ratio (INR) of ≥1.5 in patients on vitamin K antagonists (VKAs), regardless of the time elapsed between the last intake and stroke symptom onset.
* Prior diagnosis of AF or other cardioembolic arrhythmias.

Exclusion Criteria

* Symptoms not indicative of acute stroke (i.e., syncope, tonic or clonic activity, dizziness alone, confusion and amnesia alone, chronic or subacute development of focal neurological deficit).
* Ongoing parenteral (intravenous or subcutaneous) anticoagulation at the time of the index event, including bridging with heparin in patients initiating VKA.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of L'Aquila

OTHER

Sponsor Role lead

Responsible Party

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Simona Sacco

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Department of Neurology, Sveti Duh University Hospital

Zagreb, , Croatia

Site Status RECRUITING

Copenhagen University Hospital, Bispebjerg Hospital

Copenhagen, , Denmark

Site Status RECRUITING

Neurology Department, Assiut University Hospitals

Asyut, , Egypt

Site Status RECRUITING

Neurology Department, Faculty of Medicine , Ain Shams University

Cairo, , Egypt

Site Status RECRUITING

Neurology Unit, Kobry Elkoba Medical Complex

Cairo, , Egypt

Site Status RECRUITING

Université Cote d'Azur UR2CA-URRIS, Unité Neurovasculaire, CHU Hôpital Pasteur 2

Nice, , France

Site Status RECRUITING

Department of Neurology, Charite, Berlin Germany and Center for Stroke Research (CSB)

Berlin, , Germany

Site Status RECRUITING

Department of Neurology, Martin-Luther-University of Halle-Wittenberg

Halle, , Germany

Site Status RECRUITING

Neurological Clinic, Marche Polytechnic University

Ancona, , Italy

Site Status RECRUITING

SC Neurologia, Stroke Unit, Ospedale di Venere

Bari, , Italy

Site Status RECRUITING

IRCCS Istituto delle Scienze Neurologiche

Bologna, , Italy

Site Status RECRUITING

SCA Neurologia, USL Umbria 1

Città di Castello, , Italy

Site Status RECRUITING

Azienda Ospedaliero-Universitaria di Ferrara, Arcispedale Sant'Anna

Ferrara, , Italy

Site Status RECRUITING

SOD Stroke Unit, Azienda Ospedaliero Universitaria Careggi

Florence, , Italy

Site Status RECRUITING

Stroke Unit, Hospital Fabrizio Spazian

Frosinone, , Italy

Site Status RECRUITING

University of L'Aquila

L’Aquila, , Italy

Site Status RECRUITING

Neurology and Stroke Unit, ASST Grande Ospedale Metropolitano Niguarda

Milan, , Italy

Site Status RECRUITING

Neurology and Stroke Unit, AORN Antonio Cardarelli

Naples, , Italy

Site Status RECRUITING

UOC Neurologia e Stroke Unit, AOOR. Villa Sofia - Cervello

Palermo, , Italy

Site Status RECRUITING

Department of Medicine and Surgery, University of Parma

Parma, , Italy

Site Status RECRUITING

Department of Emergency Neurology and Stroke Unit, IRCCS C. Mondino

Pavia, , Italy

Site Status RECRUITING

Medicina Interna e d'Urgenza - Stroke Unit, Azienda Ospedaliera di Perugia

Perugia, , Italy

Site Status RECRUITING

Department of Emergency Neurology and Stroke Unit, Pescara Hospital

Pescara, , Italy

Site Status RECRUITING

Department of Neuroscience, Neurology Unit, S.Maria delle Croci Hospital, AUSL Romagna

Ravenna, , Italy

Site Status RECRUITING

Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia

Reggio Emilia, , Italy

Site Status RECRUITING

UOSD Stroke Unit, Azienda Ospedaliera San Camillo Forlanini

Rome, , Italy

Site Status RECRUITING

Fondazione Policlinico Universitario Agostino Gemelli

Rome, , Italy

Site Status RECRUITING

UOC Neurologia, Ospedale Provinciale "Madonna del Soccorso"

San Benedetto del Tronto, , Italy

Site Status RECRUITING

UOC Stroke Unit, Emergency and Urgency Department, AOU Senese

Siena, , Italy

Site Status RECRUITING

ASL Abruzzo 4, G.Mazzini Hospital

Teramo, , Italy

Site Status RECRUITING

SOSD Stroke Unit, Department of Head, Neck, and Neuroscience, Udine University Hospital

Udine, , Italy

Site Status RECRUITING

Stroke Unit, Neurologia A, Azienda Ospedaliera Universitaria Integrata di Verona

Verona, , Italy

Site Status RECRUITING

University Clinic of Neurology, University "Ss.Cyril and Methodius"-Faculty of Medicine

Skopje, , North Macedonia

Site Status RECRUITING

Department of Neurology, Jagiellonian University Medical College

Krakow, , Poland

Site Status RECRUITING

Lisbon Central University Hospital - ULS São José and Faculdade de Medicina, Universidade de Lisboa

Lisbon, , Portugal

Site Status RECRUITING

Hospital de Santa Maria

Lisbon, , Portugal

Site Status RECRUITING

Elias University Emergency Hospital, Carol Davila University of Medicine and Pharmacy

Bucharest, , Romania

Site Status RECRUITING

King Abdulaziz Medical City

Riyadh, , Saudi Arabia

Site Status RECRUITING

Vascular Neurology Division National Neuroscience Institute King Fahad Medical City

Riyadh, , Saudi Arabia

Site Status RECRUITING

Department of Neurology, Faculty of Medicine, P. J. Safarik University and University Hospital L. Pasteur

Košice, , Slovakia

Site Status RECRUITING

La Paz University Hospital, Universidad Autónoma de Madrid, IdiPAZ Research Institute

Madrid, , Spain

Site Status RECRUITING

Department of Medicine, University of Valladolid

Valladolid, , Spain

Site Status RECRUITING

University Teaching Hospital St. Gallen

Sankt Gallen, , Switzerland

Site Status RECRUITING

Southmead Hospital, North Bristol NHS Trust

Bristol, UK, United Kingdom

Site Status RECRUITING

St George's University Hospitals NHS Foundation Trust

London, UK, United Kingdom

Site Status RECRUITING

Department of Brain Sciences, Imperial College London

London, UK, United Kingdom

Site Status RECRUITING

Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College

London, UK, United Kingdom

Site Status RECRUITING

Countries

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Croatia Denmark Egypt France Germany Italy North Macedonia Poland Portugal Romania Saudi Arabia Slovakia Spain Switzerland United Kingdom

Central Contacts

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Simona Sacco, MD

Role: CONTACT

+39 0862433561

Matteo Foschi, MD

Role: CONTACT

+39 3478929126

Facility Contacts

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Hrvoje Budincevic, MD, PhD

Role: primary

Hanne Christensen, MD, DMSci

Role: primary

Ahmed Naslreldein, MD

Role: primary

Ahmed Elbassiouny, MD

Role: primary

Ahmed Elsaid Elsayed, MD, PhD

Role: primary

Barbara Casolla, MD, PhD

Role: primary

Christian Nolte, MD, PhD

Role: primary

Markus Otto, MD, PhD

Role: primary

Giovanna Viticchi, MD

Role: primary

Giuseppe Rinaldi, MD

Role: primary

Maria Guarino, MD

Role: primary

Silvia Cenciarelli

Role: primary

Maurizio 44124 Paciaroni, MD

Role: primary

Patrizia Nencini, MD

Role: primary

Maria Rosaria Bagnato, MD

Role: primary

Simona Sacco, MD

Role: primary

Angelo Cascio Rizzo, MD

Role: primary

Paolo Candelaresi, MD

Role: primary

Marina Mannino, MD

Role: primary

Alessandro Pezzini, MD

Role: primary

Federica Ferrari, MD, PhD

Role: primary

Maria Giulia Mosconi, MD, PhD

Role: primary

Maria Vittoria De Angelis, MD, PhD

Role: primary

Lucia Pavolucci, MD

Role: primary

Maria Luisa Zedde, MD

Role: primary

Sabrina Anticoli, MD

Role: primary

Giovanni Frisullo, MD, PhD

Role: primary

Giulio Papiri, MD

Role: primary

Rossana Tassi, MD

Role: primary

Chiara Di Felice, MD

Role: primary

Giovanni Merlino, MD, PhD

Role: primary

Manuel Cappellari, MD

Role: primary

Anita Arsovska, MD, PhD

Role: primary

Agnieszka Slowik, MD, PhD

Role: primary

Diana Aguiar de Sousa, MD, PhD

Role: primary

Ana Catarina Fonseca, MD, PhD

Role: primary

Tiu Vlad, MD, PhD

Role: primary

Athal Hussain Al-Khalaf, MD

Role: primary

Mona Al Banna, MD, MSci

Role: primary

Zuzana Gdovinova, MD, PhD

Role: primary

Blanca Fuentes, MD, PhD

Role: primary

Juan Francisco Arenillas, MD, PhD

Role: primary

Gian Marco De Marchis, MD, PhD

Role: primary

Sandeep Buddha, MD, MRCP

Role: primary

Liquin Zhang, MD, PhD

Role: primary

Roland Veltkamp, MD, PhD

Role: primary

Lucio D'Anna, MD, PhD

Role: primary

Other Identifiers

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2696 - 22/07/2024

Identifier Type: -

Identifier Source: org_study_id

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