Skip to main content

Early Treatment Can Be Initiated for A-Fib Patients With Stroke

Medically reviewed by Drugs.com.

By Elana Gotkine HealthDay Reporter

MONDAY, June 5, 2023 -- For patients with atrial fibrillation who have had an acute ischemic stroke, the incidence of a composite primary end point ranges from a reduction of about 2.8 percent to an increase of 0.5 percent for those receiving early versus later direct oral anticoagulants (DOACs), according to a study published online May 24 in the New England Journal of Medicine to coincide with the annual European Stroke Organization Conference, held from May 24 to 26 in Munich.

Urs Fischer, M.D., from the University of Basel in Switzerland, and colleagues conducted an open-label trial at 103 sites in 15 countries involving 2,013 patients with atrial fibrillation who had an acute ischemic stroke. Participants were randomly assigned to early anticoagulation (within 48 hours after a minor or moderate stroke or on day 6 to 7 after a major stroke) or later anticoagulation (day 3 or 4 after minor stroke, day 6 or 7 after moderate stroke, or day 12, 13, or 14 after major stroke). Overall, 1,006 patients received early treatment and 1,007 patients received later treatment.

The researchers found that a primary outcome event (recurrent ischemic stroke, systemic embolism, major extracranial bleeding, symptomatic intracranial hemorrhage, or vascular death within 30 days after randomization) occurred in 2.9 and 4.1 percent in the early- and later-treatment groups (risk difference, −1.18 percent; 95 percent confidence interval, −2.84 to 0.47) by 30 days. Recurrent stroke occurred in 1.4 and 2.5 percent of participants, respectively, in the early- and later-treatment groups by 30 days (odds ratio, 0.57; 95 percent confidence interval, 0.29 to 1.07) and in 1.9 and 3.1 percent, respectively, by 90 days (odds ratio, 0.60; 95 percent confidence interval, 0.33 to 1.06).

"Early treatment initiation can therefore be supported if indicated or if desired," the authors write. "The rates of the outcomes increased only slightly more at 90 days than at 30 days, findings that suggest there was not an excessive risk associated with early anticoagulation through that period."

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text (subscription or payment may be required)

More Information

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

© 2024 HealthDay. All rights reserved.

Posted June 2023

Read this next

Delay in Hospital Arrival After Stroke Linked to Social Vulnerability

THURSDAY, May 30, 2024 -- Areas with a high incidence of delay in hospital arrival after ischemic stroke are characterized by increased social vulnerability, according to a study...

Infarct Size Does Not Affect Treatment Effect of Early Versus Late DOAC

TUESDAY, May 28, 2024 -- For individuals with minor, moderate, or major stroke, the treatment effect of early versus late direct oral anticoagulant (DOAC) initiation does not...

Extreme Temperatures Linked to Increased Risk for Stroke Death

FRIDAY, May 24, 2024 -- Extreme cold and hot temperatures are associated with an increased risk for death from ischemic and hemorrhagic strokes, according to a study published...

More news resources

Subscribe to our newsletter

Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.