Why the study?
Anticoagulation after ischemic stroke with atrial fibrillation is usually delayed due to intracranial hemorrhage concerns, and the safety and efficacy of earlier initiation with direct oral anticoagulants remain unestablished.
Does early initiation of a direct oral anticoagulant reduce the composite of recurrent stroke and systemic arterial embolism compared to delayed initiation in patients with atrial fibrillation and acute ischemic stroke?
Does early initiation of a direct oral anticoagulant reduce the composite of recurrent stroke and systemic arterial embolism compared to delayed initiation in patients with atrial fibrillation and acute ischemic stroke?
The OPTIMAS trial protocol outlines a study to determine if early initiation of DOACs (within 4 days) is safe and effective compared to delayed initiation (7-14 days) in patients with AF and acute ischemic stroke.
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Early DOAC initiation within 4 days is noninferior to delayed start after AF-related stroke; reinforces evidence for prompt anticoagulation.
A 2022 study studied this question.
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