Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Rivaroxaban Versus Warfarin in Acute Ischemic Stroke With Atrial Fibrillation: Acute Stroke With Xarelto to Reduce Intracranial Bleeding, Recurrent Embolic Stroke, and Hospital Stay, Phase 2, Conceptual Multicenter Trial
Brief Summary: Rationale Acute ischemic stroke due to atrial fibrillation (AF) carries a high risk for early recurrence. In acute stage, guidelines recommend aspirin, but do not recommend anticoagulation due to the increased risk of intracranial bleeding. Since, aspirin has a limited efficacy of preventing recurrent stroke in AF, expert consensus suggests early anticoagulation in non-severe stroke with AF. The current practice for acute ischemic stroke patients with AF is delayed warfarin administration with aspirin use for non-minor stroke or immediate warfarin administration (sometimes with heparin bridging) for minor stroke. However, conventional anticoagulation with warfarin in acute ischemic stroke with AF has the following limitations: 1) risk of intracranial bleeding particularly in acute stage, 2) delayed action and transient paradoxical thrombogenic tendency due to the inhibition of protein C, resulting in the risk of early recurrent embolic stroke, and 3) prolongation of hospitalization waiting for full anticoagulation. In contrast, as compared to warfarin, rivaroxaban is advantageous for reduced risk of intracranial bleeding and immediate anticoagulation efficacy.

Goal The current trial will examine whether early initiation (within 5 days from stroke onset) of rivaroxaban as compared to conventional warfarin would reduce intracranial bleeding, recurrent embolic stroke, and hospital stay in patients with acute ischemic stroke due to AF.


Options:
A: Arm Label: Early start of NOAC; Type: ACTIVE_COMPARATOR; Interventions: Other: Early start of NOAC | Arm Label: Late start of NOAC; Type: ACTIVE_COMPARATOR; Interventions: Other: Late start of NOAC | Intervention Type: OTHER; Name: Early start of NOAC; Assigned to Arm(s): Early start of NOAC | Intervention Type: OTHER; Name: Late start of NOAC; Assigned to Arm(s): Late start of NOAC
B: Arm Label: Rivaroxaban; Type: EXPERIMENTAL; Interventions: Drug: Rivaroxaban, Drug: Matching placebo for Rivaroxaban arm (Warfarin placebo) | Arm Label: Warfarin; Type: ACTIVE_COMPARATOR; Interventions: Drug: Warfarin, Drug: Matching placebo for Warfarin arm (Rivaroxaban placebo) | Intervention Type: DRUG; Name: Rivaroxaban; Assigned to Arm(s): Rivaroxaban | Intervention Type: DRUG; Name: Warfarin; Assigned to Arm(s): Warfarin | Intervention Type: DRUG; Name: Matching placebo for Rivaroxaban arm (Warfarin placebo); Assigned to Arm(s): Rivaroxaban | Intervention Type: DRUG; Name: Matching placebo for Warfarin arm (Rivaroxaban placebo); Assigned to Arm(s): Warfarin
C: Arm Label: Rivaroxaban; Type: EXPERIMENTAL; Interventions: Drug: Rivaroxaban | Arm Label: Warfarin; Type: ACTIVE_COMPARATOR; Interventions: Drug: Warfarin | Intervention Type: DRUG; Name: Rivaroxaban; Assigned to Arm(s): Rivaroxaban | Intervention Type: DRUG; Name: Warfarin; Assigned to Arm(s): Warfarin
D: Arm Label: Early initiation of DOAC; Type: EXPERIMENTAL; Interventions: Drug: Direct oral anticoagulant (DOAC) | Arm Label: Standard Initiation of DOAC; Type: ACTIVE_COMPARATOR; Interventions: Drug: Direct oral anticoagulant (DOAC) | Intervention Type: DRUG; Name: Direct oral anticoagulant (DOAC); Assigned to Arm(s): Early initiation of DOAC, Standard Initiation of DOAC

Answer: C