Do oral anticoagulants alone improve outcomes compared to low molecular weight heparins in patients with acute ischemic stroke and atrial fibrillation?
Initiating oral anticoagulants alone between 4 and 14 days after acute ischemic stroke in patients with atrial fibrillation is associated with better outcomes compared to using low molecular weight heparins.
Acute stroke in atrial fibrillation patients is associated with high rates of ischemic recurrence and major bleeding at 90 days. This study has observed that high CHA2DS2-VASc score, high National Institutes of Health Stroke Scale, large ischemic lesions, and type of anticoagulant administered each independently led to a greater risk of recurrence and bleedings. Also, data showed that the best time for initiating anticoagulation treatment for secondary stroke prevention is 4 to 14 days from stroke onset. Moreover, patients treated with oral anticoagulants alone had better outcomes compared with patients treated with low molecular weight heparins alone or before oral anticoagulants.
Paciaroni et al. (Wed,) studied this question.