Timing of Anticoagulation After Acute Ischemic Stroke in Patients with Atrial Fibrillation

Starting treatment within 4 days rather than later leads to fewer early recurrent strokes with no significant intracranial hemorrhage signal, according to a comprehensive meta-analysis.

Direct oral anticoagulants (DOACs) are highly effective in preventing ischemic stroke in patients with atrial fibrillation (AF), but the optimal time to start anticoagulation after an acute ischemic stroke has been unclear. Clinicians need to balance the benefits of preventing early recurrent ischemic strokes against the risks for early bleeding when the brain has recently been injured. To synthesize available data on this important clinical decision, researchers in CATALYST assessed patient-level data from four recent randomized trials.

This prespecified meta-analysis included 5441 patients with AF and acute ischemic stroke who had been randomized to early DOAC initiation (≤4 days; median, 3.0 days) or later initiation (≥5 days; median, 7.2…

Reviewing Author

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Timing of Anticoagulation After Acute Ischemic Stroke in Patients with Atrial Fibrillation

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Reviewing Author