Comparison of Efficacy and Safety Among Dabigatran, Rivaroxaban, and Apixaban in Non-Valvular Atrial Fibrillation (DARING-AF)
Atrial Fibrillation
About this trial
This is an interventional treatment trial for Atrial Fibrillation focused on measuring atrial fibrillation, stroke, systemic embolism, bleeding, oral anticoagulant
Eligibility Criteria
Inclusion Criteria: Known AF (paroxysmal or persistent/ permanent) who are suitable and ready for NOAC treatment plus at least one of the following criteria
- Prior ischemic stroke, transient ischemic accident or systemic embolism
- Left ventricular ejection fraction ≤40% (documented by echocardiography or contrast ventriculography)
- Symptomatic congestive heart failure (≥ New York Heart Association Functional Class 2) within 6 months before screening
- Age ≥75 years
- Age ≥65 but <75 years with diabetes mellitus, hypertension or coronary artery disease
Exclusion Criteria: Subjects are excluded if they have at least one of the following situations before screening:
- Known severe (i.e. hemodynamically significant) mitral stenosis regardless of having received operation
- Time elapsed from the onset of stroke ≤7 days
- Bleeding tendency
- Creatinine clearance rate ≤30 mL/min
- Known active liver disease (persistent elevation of alanine aminotransferase, aspartate transaminase or alkaline phosphatase ≥3 × upper normal limit; or advanced liver cirrhosis ≥Pugh B)
- Pregnancy
- Recent documented active malignancy or radiation therapy (≤6 months) and not expected to survive 3 years
- Unwilling to give informed consent
- Conditions other than AF that required anticoagulation
- Anemia (hemoglobin level <90 g/L) or thrombocytopenia (platelet count <100 × 109/L)
- Persistent uncontrolled hypertension (systolic blood pressure >180 mmHg or diastolic blood pressure >100 mmHg)
- Active infective endocarditis
- Patients considered unreliable by the investigator or have a life expectancy less than the expected duration of the trial because of concomitant disease, or has any condition which in the opinion of the investigator, would not allow safe participation in the study
Sites / Locations
- National Cheng Kung University HospitalRecruiting
- Tainan Hospital Ministry of Health and Welfare
- National Cheng Kung University Hospital Dou-Liou Branch
- E-DA Hospital
- Tainan Municipal HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
Active Comparator
Dabigatran
Rivaroxaban
Apixaban
oral dabigatran etexilate capsule 110 or 150 mg (110 mg in specific population) bid for entire study period
oral rivaroxaban film-coated tablet 15 or 20 mg (10 or 15 mg in specific population) qd for entire study period
oral apixaban 5 mg (2.5 mg in specific population) bid for entire study period