OPtimal TIMing of Anticoagulation after acute ischaemic Stroke: a randmoised controlled trial

OPTIMAS is a trial investigating the optimal timing of anticoagulation after acute ischaemic stroke in patients with a confirmed clinical diagnosis of atrial fibrillation (AF).  The trial is a UK multicentre, partially blinded randomised controlled trial. Our local PI for the study is Dr Fergus Doubal.

Patients will be approached for their consent ideally within the first 72 hours after stroke onset but can be up to 96 hours. If patients are unable to consent due to incapacity, their welfare guardian or nearest relative can be approached for participation in the trial.  Prior to randomisation, demographics, NIHSS, cognitive and lifestyle questionnaires will be completed.  They will then be randomised to receive either early intervention of any direct oral anticoagulant (within 4 days) versus standard initiation (between day 7 and day 14) after symptom onset.  Participants will be followed up at 90 days following randomisation. Our recruitment target for NHS Lothian is one patient per month. The research team are awaiting local R&D approval in order to get the green light to start recruitment in Edinburgh.