Bridging Therapy with Heparin in Patients with Stroke and Atrial Fibrillation

Following a stroke in the setting of atrial fibrillation (AF), oral anticoagulation therapy is recommended. Clinicians can prescribe either vitamin K antagonists (VKAs), such as warfarin, or novel oral anticoagulants (NOACs). VKAs frequently take several days to achieve anticoagulation in the target range. Therefore, bridging therapy with heparin or low-molecular-weight heparin is sometimes used. These authors evaluated the outcomes of patients who did or did not receive bridging therapy in a multicenter registry. The primary study outcome was the 90-day rate of recurrent ischemic stroke, transient ischemic attack, or systemic embolism (ischemic endpoints) or symptomatic cerebral or major extracranial bleeding (hemorrhagic endpoints).

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