What question did this study set out to answer?

The research aims to explore characteristics linked to ischemic strokes occurring despite oral anticoagulation in atrial fibrillation patients.

May 8, 2026European Stroke JournalOpen Access

Abstract Number: Esoc2026lb72 Characteristics of Patients With Ischemic Stroke Despite Oral Anticoagulation for Atrial Fibrillation

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Why the study?

What clinical characteristics are associated with ischemic stroke despite oral anticoagulation in patients with atrial fibrillation?

Population

2,551 consecutive patients with ischemic stroke and AF who underwent carotid imaging

Comparison

Stroke despite OAC vs known AF not on OAC vs newly diagnosed AF

Design

Multicenter prospective registry study

Authors

DSDimitrios SagrisUniversity of Thessaly EKEleni KorompokiAlexandra Hospital AAAnastasia AdamouAHEPA University Hospital

Discussion

Member takes

Implication

May warrant optimized prevention beyond standard OAC in vulnerable AF patients; extends risk factor data with Level 2 RCT evidence.**[[1]](https://pmc.ncbi.nlm.nih.gov/articles/PMC10532406/)[[2]](https://www.neurology.org/doi/10.1212/WNL.

Key Points

The research aims to explore characteristics linked to ischemic strokes occurring despite oral anticoagulation in atrial fibrillation patients.
Prospective analysis of 2,551 patients from 10 stroke registries with ischemic stroke and atrial fibrillation.
Patients categorized into those with stroke despite oral anticoagulation, known AF not on OAC, and newly diagnosed AF.
Multivariable logistic regression was utilized to determine clinical characteristics associated with breakthrough strokes.
30.1% of patients experienced a breakthrough stroke while on OAC treatment.
Risk factors for breakthrough stroke included older age (aOR:1.02/year), prior stroke/TIA (aOR:1.67), and persistent AF (aOR:1.49).
Mild ipsilateral carotid stenosis was associated with breakthrough stroke (aOR:1.37), while more severe stenosis was not linked.

Structured PICO

What clinical characteristics are associated with ischemic stroke despite oral anticoagulation in patients with atrial fibrillation?

Population

2,551 consecutive patients with ischemic stroke and atrial fibrillation (AF) who underwent carotid imaging from 10 stroke registries

Intervention

Oral anticoagulation (OAC) treatment prior to stroke (breakthrough stroke)

Comparator

Known AF not on OAC, or newly diagnosed AF

Outcome

Clinical characteristics associated with ischemic stroke despite OAC treatment

Breakthrough ischemic strokes in AF patients on oral anticoagulation are associated with older age, higher cardiovascular risk burden, and mild ipsilateral carotid stenosis, suggesting competing stroke mechanisms beyond cardioembolism.

Cite This Study

Sagris et al. (2026) studied this question.

synapsesocial.com/papers/69fd7ec6bfa21ec5bbf07114 https://doi.org/10.1093/esj/aakag023.1920

Topics

Atrial fibrillation Anticoagulation in AF Persistent AF management

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Abstract Number: Esoc2026lb72 Characteristics of Patients With Ischemic Stroke Despite Oral Anticoagulation for Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Abstract Number: Esoc2026lb72 Characteristics of Patients With Ischemic Stroke Despite Oral Anticoagulation for Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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