The Rhythm Evaluation for AntiCoagulaTion with Continuous Monitoring of Atrial Fibrillation (REACT-AF) clinical trial compares the current standard of care for AF versus a novel strategy of precise, time-delimited, direct oral anticoagulation (DOAC) guided by an AF-sensing smartwatch.
AF is a condition of sustained arrhythmia and is a major cause of stroke. The current standard of care includes chronic, daily DOAC, which reduces the risk of stroke in patients with AF but increases the risk of hemorrhage, including fatal hemorrhage. These competing risks have made stroke prevention among the most challenging aspects of AF management and underscore the need for innovative approaches.
REACT-AF is a multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE design), controlled trial aimed at assessing the efficacy and safety of this novel strategy compared to the current standard of care. This paradigm allows for precision-targeted, time-delimited (1 month) anticoagulation given only in response to a prolonged AF episode, which is expected to reduce bleeding events while maintaining stroke protection. This paradigm shift toward individualized or “precision” stroke prevention could reduce anticoagulant use, hemorrhage risk, healthcare utilization, and cost for millions of AF patients worldwide.
Johns Hopkins University is collaborating with Northwestern University, Stanford University, and University of California San Francisco on this National Institutes of Health–funded trial. JHU BIOS Clinical Trial Coordinating Center serves as the data coordinating center for this study.
ClinicalTrials.gov Identifier: NCT05836987