Posted on April 10: McMaster leads landmark trial in prevention of vascular events in patients with atrial fibrillation

Patient enrolment will soon begin in the ACTIVE trial (Atrial fibrillation Clopidogrel Trial with Irbesartan for the prevention of Vascular Events), the largest randomised trial program ever conducted in atrial fibrillation. "The ACTIVE trial is intended to respond to a largely unmet medical need in the treatment of patients with atrial fibrillation (AF), who are at an increased risk of life-threatening vascular events such as stroke, myocardial infarction and death," said Stuart Connolly, professor of medicine at McMaster, and principal investigator of the ACTIVE trial. "Current treatment with oral anticoagulants is not suitable for many AF patients since it is limited by specific contraindications, monitoring constraints and poor compliance. Aspirin, the only standard alternative to oral anticoagulants, provides only modest protection in this patient population." Salim Yusuf, professor of medicine and director of the Population Health Research Institute at McMaster, is chair of the ACTIVE Steering Committee. The multicentre, multinational ACTIVE trial includes three primary objectives in investigating the long-term efficacy and safety of clopidogrel plus ASA for the prevention of vascular events in patients with atrial fibrillation. Clopidogrel plus aspirin, which inhibits platelet aggregation, will be compared with standard oral anticoagulant therapy in one trial (ACTIVE W), and compared with ASA alone in a second trial (ACTIVE A). The goal of treatment is the prevention of vascular events in patients with AF. A third integrated trial is also evaluating whether the angiotensin II receptor antagonist, irbesartan, is superior to placebo (in addition to usual blood pressure lowering therapy) in preventing vascular events in patients with atrial fibrillation (ACTIVE I).

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