Key result
Early anticoagulation after large ischemic stroke is linked to no recurrent events and low sICH risk.
Why the study?
Clinical trial data indicate early anticoagulation is generally safe after ischemic stroke, but real-world data regarding safety in large strokes are limited.
Does early anticoagulation prevent recurrent ischemic and major hemorrhagic events in patients with acute large ischemic stroke?
Population
Consecutive patients with acute large ischemic stroke (volume ≥60 mL)
Comparison
Timing of anticoagulation initiation
Design
Multicenter observational study
Follow-up
90 days
Authors
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Should not yet change practice for early anticoagulation after large stroke; leaves open safety signals for randomized confirmation.
Cohort (n=155)
Yes
Does early anticoagulation prevent recurrent ischemic and major hemorrhagic events in patients with acute large ischemic stroke?
Absolute Event Rate: 13% vs 9.5%
p-value: p=0.980
Early anticoagulation after large ischemic stroke (≥60 mL) appears safe, with a low risk of symptomatic intracranial hemorrhage and no recurrent ischemic strokes observed in the early treatment group.
Muppa et al. (2025) conducted a cohort in Acute large ischemic stroke with atrial fibrillation (n=155). Early anticoagulation vs. Late anticoagulation was evaluated on Median time to anticoagulation initiation in patients with versus without combined recurrent ischemic and major hemorrhagic events within 90 days (days) (p=0.980). Early anticoagulation within 7 days after large ischemic stroke was associated with no recurrent ischemic events and a low risk of symptomatic intracranial hemorrhage.
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