Does adjusting anticoagulation therapy or switching to warfarin improve outcomes in patients presenting with ischemic strokes while using a DOAC?
Adjusting DOAC therapy or switching to warfarin after an ischemic stroke while on a DOAC does not improve outcomes and may increase the risk of recurrent stroke, bleeding, and death compared to continuing DOACs.
Post-stroke adjustments to anticoagulation therapy-whether altering the drug or its dosage-do not yield additional benefits. In addition, the results suggest that warfarin may be less effective than DOACs for preventing stroke recurrence, bleeding complications, and death in this patient population.
Telles et al. (Tue,) studied this question.