Timing of Anticoagulants in Stroke Related to Atrial Fibrillation

A randomized trial compared early with late initiation of direct oral anticoagulant medications.

Traditionally, when warfarin was started after a stroke related to atrial fibrillation (AF), starting the medication was delayed due to concerns about hemorrhagic transformation of the infarct. With the widespread use of direct oral anticoagulant (DOAC) medications, which are associated with a reduced rate of brain hemorrhage compared with warfarin, some clinicians have wondered about early start of DOACs following a stroke. In this trial, patients at 34 centers in Sweden were randomly assigned to early (within 4 days) or delayed (5–10 days) start of DOACs after an ischemic stroke with AF. The primary outcome was the combined rate of recurrent ischemic stroke, symptomatic intracerebral hemorrhage (sICH), and all-cause mortality at 90 days. …

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Timing of Anticoagulants in Stroke Related to Atrial Fibrillation

Topics

Reviewing Author