The rhythm evaluation for anticoagulation with continuous monitoring of atrial fibrillation trial (react-AF)

Active Cooperative Agreement Awarded Last action

Award ID
UH3HL165065
Recipient
Awarding agency
Obligated
$18,213,740

Award facts

Assistance listing
93.837 Cardiovascular Diseases Research
Completion date 60% complete
Funding agency
National Institute of Neurological Disorders and Stroke National Institutes of Health, Department of Health and Human Services
Place of performance
Chicago, IL 60611, USA

Award details come from USAspending.gov.

Description

Abstract
Purpose: the rhythm evaluation for anticoagulation with continuous monitoring of atrial fibrillation (react AF) clinical trial will compare the efficacy and safety of two treatment strategies for stroke prevention in atrial fibrillation (AF): the current standard of continuous direct oral anticoagulation (doac) versus a novel strategy of precision, time-delimited doac initiated only in response to a = 1-hour AF episode detected by an AF-sensing smartwatch (afsw (apple watch)). Rationale: stroke risk is often temporally related to AF onset and duration, but bleeding risk continues as a constant risk of anticoagulation exposure even during long AF-free periods when stroke risk may be low. React- AF will evaluate the benefits and risks of withholding anticoagulation during prolonged periods of sinus rhythm as guided by an afsw. Compared with continuous doac, afsw-guided, time-delimited doac treatment may reduce bleeding events while maintaining stroke protection. This has potential to improve important major clinical outcomes and quality of life while reducing health care utilization. Design: react-AF is a multicenter prospective, randomized, open label, blinded endpoint (probe design) trial comparing the current standard of care of continuous doac administration versus time-delimited doac treatment guided by an afsw in patients with a history of paroxysmal or persistent AF and low-to-moderate stroke risk (CHA2DS2-vasc score 1-4). The study will have an initial explanatory phase i followed by an explanatory phase II with pragmatic elements. Primary aim 1 (efficacy objective): to assess whether afsw-guided, time-delimited doac therapy is non- inferior to continuous doac therapy for a composite endpoint that includes: (1) ischemic stroke; (2) systemic embolism; (3) all-cause mortality. Hypothesis: time-delimited doac therapy is non-inferior to continuous doac therapy for the composite endpoint of ischemic stroke, systemic embolism, and all-cause mortality. Primary aim 2 (safety objective): to assess whether afsw-guided, time-delimited doac therapy significantly reduces major bleeding events compared to continuous doac therapy. Hypothesis: major bleeding events will be significantly lower in participants randomized to afsw-guided, time- delimited doac therapy compared with participants receiving continuous doac therapy. Exploratory aim 1: to compare overall participant satisfaction with anticoagulation management between the two study arms. Exploratory aim 2: to compare estimates of health-related resource utilization in participants randomized to control versus experimental arms.

Transactions

Action Obligated Date
Amendment $0
Amendment $463,058
Amendment $2,608,085
Amendment $0
Amendment $0
Amendment $0
Amendment $1,096,804
Amendment $1,096,804
Amendment $1,584,092
Amendment $1,584,092
Amendment $1,584,092
Amendment $1,268,896
Original award $5,075,586
Show all 13

Subawards

Subrecipient Amount Awarded
The Johns Hopkins University The Rhythm Evaluation for Anticoagulation with Continuous Monitoring of Atrial Fibrillation Trial (REACT-AF) $514,418
University Of Wisconsin System $5,000
University Of New Mexico $2,242
Regents Of The University Of Minnesota $4,582
Cis Clinical Research, LLC $27,729
The General Hospital Corporation $66,278
University Of California, LOS Angeles $8,568
Georgia Arrhythmia Consultants And Research Institute, LLC $25,482
Presbyterian Healthcare Services $9,610
Weill Medical College Of Cornell University $25,482
ST. Joseph's Hospital, Inc. $11,857
Emory University $7,982
University Of Miami $9,610
James River Cardiology $66,278
The University Of Texas Southwestern Medical Center $7,982
Allegheny Singer Research Institute $29,411
Lahey Clinic, Inc. $7,982
The Feinstein Institutes For Medical Research $36,402
Endeavor Health Clinical Operations $25,482
The Johns Hopkins University $27,729
Baylor College Of Medicine $36,402
New York Medical College $7,982
Sarasota County Public Hospital District $36,402
University Of Southern California $36,402
The Trustees Of Columbia University In The City Of New York A03; The Rhythm Evaluation for Anticoagulation with Continuous Monitoring of Atrial Fibrillation Trial (REACT-AF) $16,352
Rush University Medical Center The Rhythm Evaluation for Anticoagulation with Continuous Monitoring of Atrial Fibrillation Trial (REACT-AF) $23,854
University Of Illinois $16,352
Medical University Hospital Authority The Rhythm Evaluation for Anticoagulation with Continuous Monitoring of Atrial Fibrillation Trial (REACT-AF)\ $9,610
Scripps Health The Rhythm Evaluation for Anticoagulation with Continuous Monitoring of Atrial Fibrillation Trial (REACT-AF) $7,982
The Methodist Hospital Research Institute $36,402
Allina Health System $66,278
William Beaumont Hospital $11,857
University Of Florida $7,982
Loyola University Of Chicago $9,610
University Of Arizona $9,610
South Denver Cardiology Associates, P.C. $7,982
Winter Haven Hospital, Inc. $9,610
Wake Forest University Health Sciences $24,916
University Of New Mexico $36,402
University Of Texas Health Science Center At Houston $9,610
Pennsylvania State University $36,402
New York University $9,610
The Medical University Of South Carolina $27,729
University Of Oklahoma $9,610
Alexian Brothers Health System $36,402
City Of Wooster $9,610
HMH Hospitals Corporation $23,854
Texas Cardiac Arrhythmia Research Foundation $11,857
Henry Ford Health System $16,352
University Of Utah $66,278
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Quick answers

Who received award UH3HL165065?

UH3HL165065 was awarded to Northwestern University by National Heart Lung and Blood Institute (National Institutes of Health) on August 25, 2022.

How much is award UH3HL165065 worth?

$18,213,740 has been obligated on UH3HL165065.

Which agency awarded UH3HL165065?

National Heart Lung and Blood Institute (National Institutes of Health) awarded UH3HL165065, with funding from National Institute of Neurological Disorders and Stroke (National Institutes of Health).

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