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When to initiate anticoagulation after an ischemic stroke in patients with atrial fibrillation (AF) is a common clinical question. Some guidelines suggest delayed initiation (typically 10–14 days after stroke onset) to minimize the risk for hemorrhagic transformation. However, the risk for brain hemorrhage is lower with direct oral anticoagulants (DOACs) than with vitamin K antagonists, and early use of DOACs could be safe. Now, investigators report on a trial that enrolled 3621 patients (mean age, 79 years; 45% women) with an ischemic stroke and AF for whom the treating clinician was unsure about providing early (<4 days after stroke onset) or delayed initiation of DOAC therapy (7–14 days after onset). Clinicians could prescribe any DOAC m…