Timing of Oral Anticoagulation After Stroke due to Atrial Fibrillation

The timing of initiation of oral anticoagulation after an ischemic stroke due to atrial fibrillation needs to balance the risk for recurrent ischemic events with the risk for hemorrhagic transformation. Few randomized trials have examined different strategies in this scenario. Now, investigators have performed a randomized trial comparing a strategy of early direct oral anticoagulant (DOAC) initiation or a later-initiation strategy. The early-initiation group started a DOAC within 48 hours after a mild or moderate stroke or on day 6 to 7 after a severe stroke. The later-initiation group started medication on days 3–4, 6–7, or 12–14 for a mild, moderate, or severe stroke. The primary study outcome was a composite of recurrent ischemic stroke…