Clinical Question
Should I anticoagulate this patient?
Synthesises 3 trialsAF timing, ESUS, and recurrence prevention
What does the guideline say?
- §4.9 Anticoagulants· 2026
In carefully selected (eg, milder severity) patients with AIS with atrial fibrillation, a strategy of early oral anticoagulation poststroke is low risk and is reasonable compared with a strategy of delayed anticoagulation, although the efficacy of early anticoagulation for prevention of early recurrent stroke is not established.
The trials cited in the guideline's supportive text appear below.
Trials in this question· 3
TIMING2022
NI metRD −1.79%
Early DOAC (≤4 d) after AF-related ischemic stroke noninferior to delayed start.
NI metRD −1.79%
OPTIMAS2024
NI metRD 0.000
Early DOAC (≤4 d) noninferior to delayed start after AF-related stroke in the largest trial to date.
NI metRD 0.000
ELAN2023
NI metRD −1.18%
Early DOAC start after AF-related stroke is non-inferior with reassuring safety (sICH 0.2% both arms).
NI metRD −1.18%
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