The New England Journal of MedicineEarly versus Later Anticoagulation for Stroke with Atrial Fibrillation

Evaluating the Timing of DOAC Initiation Post-Stroke: Key Findings

Here are the key findings from a recent multi-country, open-label research that explores the best time to start direct oral anticoagulants (DOACs) in atrial fibrillation patients after a stroke.

• The trial was conducted across 103 sites in 15 countries, involving 2013 participants.
• Participants were randomly assigned to early or later anticoagulation with DOACs post-stroke.
• Early anticoagulation was initiated within 48 hours post minor or moderate stroke, or on day 6 or 7 post major stroke.
• Later anticoagulation was initiated on day 3 or 4 post minor stroke, day 6 or 7 post moderate stroke, or day 12, 13, or 14 post major stroke.
• The primary outcome event occurred in 2.9% of the early-treatment group and 4.1% of the later-treatment group by 30 days.
• Recurrent ischemic stroke was lower in the early-treatment group at both 30 and 90 days.
• Symptomatic intracranial hemorrhage was observed in 0.2% of participants in both groups by 30 days.