What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation with acute ischemic stroke despite anticoagulation (n=55). Intervention: Oral anticoagulation (DOACs or vitamin K antagonists). Primary outcome: Early unfavorable functional outcome (mRS≥3 at discharge).

May 8, 2026European Stroke JournalOpen Access

Abstract Number: Esoc2026a2330 Clinical Phenotype of Patients With Atrial Fibrillation Presenting With Ischemic Stroke Despite Anticoagulation

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Key result

Ischemic stroke despite anticoagulation in AF leaves ~53% of patients with early unfavorable functional outcomes.

n=55

Population

55 consecutive patients with acute IS and anticoagulated AF prior to stroke onset

Design

Prospective single-center cohort study

Follow-up

At discharge

Authors

VVVeronika VasilevaUniversity Hospital Dr. Georgi Stranski MDMaya DanovskaUniversity Hospital Dr. Georgi Stranski YTYoanna TodorovaUniversity Hospital Dr. Georgi Stranski

Discussion

Member takes

Implication

Supports prognostic caution for DOAC-treated stroke patients; leaves open role of acute therapies to improve functional recovery.

Key Points

This study aims to analyze the clinical characteristics of patients with atrial fibrillation experiencing ischemic stroke despite anticoagulation and to identify related risk factors.
Conducted a prospective, single-center cohort study
Included 55 consecutive patients with acute ischemic stroke and anticoagulated atrial fibrillation
Recorded demographic data, comorbidities, anticoagulant regimen, and evaluated stroke severity using NIHSS and functional outcome using mRS.
Median CHA₂DS₂-VASc score was 5 indicating a high thromboembolic risk
Moderate stroke severity was recorded with a median NIHSS score of 7
Early unfavorable functional outcome (mRS≥3) occurred in 52.7% of patients, more closely associated with age and comorbidities rather than anticoagulant regimen.

Study Design

Type

Cohort (n=55)

Multicenter

Structured PICO

Population

55 patients with acute ischemic stroke and atrial fibrillation who were anticoagulated (DOACs or vitamin K antagonists) prior to stroke onset, median age 79 years, 40% male, median CHA₂DS₂-VASc score 5.

Intervention

Prior oral anticoagulation (DOACs or vitamin K antagonists)

Outcome

Stroke severity assessed by NIHSS and early functional outcome evaluated using mRS at dischargehard clinical

Patients with atrial fibrillation who experience an ischemic stroke despite anticoagulation represent a high-risk phenotype where outcomes are driven primarily by advanced age and comorbidities rather than the specific anticoagulant regimen.

Cite This Study

Vasileva et al. (2026) conducted a cohort in Atrial fibrillation with acute ischemic stroke despite anticoagulation (n=55). Oral anticoagulation (DOACs or vitamin K antagonists) was evaluated on Early unfavorable functional outcome (mRS≥3 at discharge). In patients with atrial fibrillation experiencing ischemic stroke despite anticoagulation, early unfavorable functional outcome (mRS≥3) occurred in 52.7% of patients.

synapsesocial.com/papers/69fd7f86bfa21ec5bbf08093 https://doi.org/10.1093/esj/aakag023.1798

Topics

Atrial fibrillation Anticoagulation in AF Persistent AF management

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Abstract Number: Esoc2026a2330 Clinical Phenotype of Patients With Atrial Fibrillation Presenting With Ischemic Stroke Despite Anticoagulation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Abstract Number: Esoc2026a2330 Clinical Phenotype of Patients With Atrial Fibrillation Presenting With Ischemic Stroke Despite Anticoagulation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

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