Statistical Analysis Plan (SAP): A randomized controlled trial of intensive blood pressure control on cardiovascular risk reduction in patients with atrial fibrillation: the CRAFT trial

The CRAFT trial is designed to evaluate the effects of intensive blood pressure (BP) control in reducing cardiovascular (CV) risks in patients with atrial fibrillation (AF). The trial is a randomized controlled, open-label, parallel-group study, where patients are assigned to either an intensive BP control group (home systolic BP [SBP] <120 mmHg) or a standard BP control group (SBP <135 mmHg). The trial aims to determine whether more intensive BP control reduces the hierarchical composite outcome of time to CV death, stroke events, myocardial infarction (MI), heart failure hospitalizations (HFH), and their respective times to first events compared to standard BP control. The primary analysis will involve the win-ratio method, where the effect of the intervention will be quantified in terms of win ratios and 95% confidence intervals (CI). Secondary outcomes will include time to CV death, number of strokes, MI, HFH, and other related cardiovascular events, analyzed using Cox proportional hazards models. For the sensitivity analysis, the hierarchical composite outcome analysis will be repeated using matched win-ratio analysis. The sample size of 1675 patients will provide 80% power to detect a win-ratio of 1.50 for intensive BP control relative to standard BP control. This study will provide reliable evidence on the optimal BP target for improving cardiovascular outcomes in AF patients.