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Despite the effectiveness of direct oral anticoagulants (DOACs) in preventing stroke in patients with atrial fibrillation (AF), a finite proportion of patients have breakthrough strokes. The optimal antithrombotic strategy for these patients is uncertain. Options include continuing the same DOAC, switching to another DOAC, switching to warfarin, or adding antiplatelet therapy. These authors conducted a population-based, observational study among all public hospitals in Hong Kong over a 6-year period. Patients with strokes while on DOAC therapy were identified and the antithrombotic strategy following the event was recorded. The researchers evaluated medical records to assess recurrent ischemic stroke; intracranial hemorrhage (ICH) and morta…