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Most patients with atrial fibrillation (AF) are recommended to receive oral anticoagulant (OAC) medication. Direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) can be used, with guidelines currently recommending DOACs. However, for AF patients who experience a stroke despite DOAC treatment, the optimal treatment strategy has not been studied extensively. In this study, researchers from Taiwan analyzed outcomes of patients with AF and ischemic stroke while taking DOAC medications (DOAC failure). Patients were followed for at least 1 year; total follow-up time was 14 years. The main goal was to analyze vascular outcomes after switching to either a different DOAC or to VKA therapy. Main outcomes were ischemic stroke, major card…