Managing acute ischemic stroke in patients with concurrent atrial fibrillation requires careful consideration of anticoagulation timing. The following clinical situation describes a specific, evidence-guided scenario for this population.
Acute ischemic stroke occurring in a patient with atrial fibrillation, where the patient is carefully selected — for example, on the basis of milder stroke severity.
In carefully selected patients meeting this profile, an approach involving early oral anticoagulation with a direct oral anticoagulant poststroke may be considered — the specific timing and eligibility criteria are defined in the full protocol.
Complete regimen, sequencing, and eligibility criteria available in the full protocol.
DOI: 10.1161/STR.0000000000000513
In carefully selected (eg, milder severity) patients with AIS with atrial fibrillation, a strategy of early oral anticoagulation poststroke is low risk and is reasonable compared with a strategy of delayed anticoagulation, although the efficacy of early anticoagulation for prevention of early recurrent stroke is not established.
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