The Canadian Institutes of Health Research (CIHR) has awarded more than $3 million in funding to support the work of PHRI researchers through the Fall 2025 Project Grant competition.
DANCE Trial: Defining the Safest Blood Thinner After Cardiac Surgery
The Direct Oral Anticoagulation versus Vitamin K Antagonist after Cardiac Surgery (DANCE) trial, led by scientist Emilie Belley‑Côté and senior scientist Richard Whitlock, has received $2,570,400 over five years in CIHR funding.
Among people who need cardiac surgery, at least 10 per cent already have an abnormal heart rhythm called atrial fibrillation (AF). AF is also the most common complication after cardiac surgery and can affect up to 60 per cent of patients. Blood thinners are used to reduce the risk of stroke in people with AF. Newer blood thinners, known as direct oral anticoagulants (DOACs), are often preferred because they are easier to use and generally safer for patients. However, small studies have suggested that using DOACs shortly after cardiac surgery may lead to a higher risk of bleeding compared with older blood thinners called vitamin K antagonists, such as warfarin (Coumadin). The evidence available to guide doctors on which blood thinner to use after cardiac surgery is limited and not very strong.
DANCE will randomly assign patients who need a blood thinner after cardiac surgery to receive either a DOAC or a vitamin K antagonist. The study will include 3,500 patients from 50 centres in Canada and other countries. It will examine whether DOACs are noninferior than vitamin K antagonists in terms of major bleeding within 30 days in patients who require anticoagulation for atrial fibrillation soon after cardiac surgery. The findings from the DANCE trial will help determine the safest blood thinner for patients during the early period after cardiac surgery and improve patient safety.
DO-IT Trial: Expanding Stroke Treatment Options for Patients on Anticoagulants
The Direct Oral Anticoagulants International Thrombolysis (DO‑IT) trial, led by investigator Luciana Catanese, scientist Aristeidis Katsanos, and senior scientist Ashkan Shoamanesh, has received $546,976 over three years in CIHR funding.
DO-IT aims to improve the care of patients with stroke who are taking strong blood thinners (anticoagulants) at the time of their stroke. Stroke is the most common cause of physical disability in Canada. It often occurs when a blood clot clogs a blood vessel in the brain leaving it without blood flow and oxygen. One of the most effective treatments for clot-related strokes is intravenous thrombolysis (IVT), a clot‑busting medication that can restore blood flow and reduce disability when administered within 4.5 hours of symptom onset.
However, many stroke patients are already taking anticoagulants and are often excluded from receiving IVT due to concerns about bleeding risk. As the number of people taking anticoagulants continues to grow, this limitation affects an increasing proportion of stroke patients.
Recent research suggests that IVT may be safe in selected patients taking anticoagulants, but high‑quality randomized evidence is needed.
The DO‑IT trial will enroll 100 stroke patients at 10 hospitals across Canada who are taking anticoagulants and are otherwise eligible for IVT. Participants will be randomly assigned to receive either IVT or usual care and will be followed for 90 days to assess bleeding risk and functional recovery.
The trial aims to determine whether IVT can improve functional independence without increasing bleeding risk in this population. Findings from DO‑IT have the potential to transform stroke care and improve outcomes for an estimated 500,000 people worldwide each year who experience stroke while taking anticoagulants.
