• Annals of surgery · Jul 2022

    Randomized Controlled Trial

    Rationale and Design of the Randomized Controlled Trial of New Oral Anticoagulants Versus Warfarin for Post Cardiac Surgery Atrial Fibrillation: The NEW-AF Trial.

    • Asishana A Osho, Philicia Moonsamy, Breanna R Ethridge, Gregory A Leya, David A D'Alessandro, Arminder S Jassar, Mauricio A Villavicencio, Serguei I Melnitchouk, George Tolis, Nathaniel B Langer, Masaki Funamoto, Selena S Li, Katia M Colon, Navyatha Mohan, Joseph J Locascio, Steven A Lubitz, Oluwaseun Akeju, and Thoralf M Sundt.
    • Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts.
    • Ann. Surg. 2022 Jul 1; 276 (1): 200-204.

    ObjectiveThis manuscript describes the rationale and design of a randomized, controlled trial comparing outcomes with Warfarin vs Novel Oral Anticoagulant (NOAC) therapy in patients with new onset atrial fibrillation after cardiac surgery.BackgroundNew onset atrial fibrillation commonly occurs after cardiac surgery and is associated with increased rates of stroke and mortality. in nonsurgical patients with atrial fibrillation, NOACs have been shown to confer equivalent benefits for stroke prevention with less bleeding risk and less tedious monitoring requirements compared with Warfarin. However, NOAC use has yet to be adopted widely in cardiac surgery patients.MethodsThe NEW-AF study has been designed as a pragmatic, prospective, randomized controlled trial that will compare financial, convenience and safety outcomes for patients with new onset atrial fibrillation after cardiac surgery that are treated with NOACs versus Warfarin.ResultsStudy results may contribute to optimizing the options for stroke prophylaxis in cardiac surgery patients and catalyze more widespread application of NOAC therapy in this patient population.ConclusionsThe study is ongoing and actively enrolling at the time of the publication. The trial is registered with clinicaltrials.gov under registration number NCT03702582.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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