Early treatment of Atrial fibrillation for Stroke prevention Trial in acute STROKE

Patients with acute ischemic stroke and atrial fibrillation are at high risk for recurrent stroke and other adverse cardiovascular complications. Usual care comprises oral anticoagulation and rate control. However, it is unclear, whether existing interventions for early rhythm control reduce the risk of adverse cardiovascular outcomes in these vulnerable patients. EAST-STROKE (Early treatment of Atrial fibrillation for Stroke prevention Trial in acute STROKE) is set out to tackle and reduce the individual and societal burden of death and disability by providing evidence for effective secondary prevention using readily available interventions in these patients. To this end, EAST-STROKE is an investigator-initiated, prospective, randomized, open, blinded endpoint assessment (PROBE) multi- trial to test whether early rhythm control therapy prevents adverse cardiovascular outcome in patients with acute ischemic stroke and atrial fibrillation compared to usual care. Up to 1,746 patients will be enrolled. Trial organisation relies on a network of experienced clinical researchers, patient representatives and Health Economics experts. Outcome evaluation will involve a comprehensive array of clinical and safety parameters, health and socio-economic outcomes including patient reported outcome measures. We will also perform cost-effectiveness analyses to address the needs of payers and ease implementation into reimbursement schemes. The project addresses a major health burden and will provide evidence for more effective prevention of adverse outcomes in an area of high public health need. We expect that the results of EAST-STROKE will be implemented rapidly throughout Europe, will support health equity, and will prevent more than 150 thousand recurrent strokes or adverse cardiovascular outcomes over a period of five years. By this, EAST-STROKE will lead to significant cost-savings to European health systems and societies.