This review highlights the roles of DOACs and LAA exclusion in stroke prevention for AF patients, while noting that the optimal timing for anticoagulation after acute ischemic stroke is still being studied.
-VASc score, was traditionally achieved with warfarin; however, direct oral anticoagulants have solidified their role as safe and effective alternatives. Additionally, left atrial appendage exclusion has emerged as a viable option in patients intolerant of anticoagulation. When patients with AF have an acute stroke, the timing of initiation or resumption of anticoagulation for secondary stroke prevention has to be balanced against the risk of hemorrhagic conversion. Multiple randomized clinical trials are currently underway to determine the best timing for administration of anticoagulants following acute ischemic stroke.
Migdady et al. (Tue,) studied this question.