Key result
Early DOAC initiation within ~5 to 7 days optimizes net clinical benefit after cardioembolic stroke.
Why the study?
What are the optimal approaches for prescribing direct oral anticoagulants for secondary prevention in patients with cardioembolic stroke and atrial fibrillation across various complex clinical scenarios?
What are the optimal approaches for prescribing direct oral anticoagulants for secondary prevention in patients with cardioembolic stroke and atrial fibrillation across various complex clinical scenarios?
This review provides guidance on the complex decision-making process for prescribing direct oral anticoagulants in patients with atrial fibrillation and cardioembolic stroke, particularly in challenging clinical scenarios.
May guide DOAC timing decisions in cardioembolic AF stroke; extends prior synthesis but leaves optimal protocols open for RCTs.
The article discusses the clinical features of cardioembolic stroke (CES). Approaches to the examination of a patient with clinical suspicion of CES are discussed within the framework of the concept of atrial cardiopathy and its main markers. The principles for choosing the timing of oral anticoagulant administration for the purpose of secondary prevention are presented. The article discusses the special aspects of direct oral anticoagulants prescription in difficult clinical situations, in particular, in elderly and senile patients, after reperfusion therapy, with the development of hemorrhagic transformation, in the presence of combined atherosclerosis, cerebral microangiopathy, anamnesis of intracerebral hemorrhage, as well as severe cognitive impairment. Approaches to the choice of oral anticoagulant in terms of purely clinical benefit are presented.
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Кулеш et al. (2022) conducted a review in Ischemic stroke with atrial fibrillation. Direct oral anticoagulants (DOACs) was evaluated.
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