For patients with acute ischemic stroke with atrial fibrillation (AF), starting anticoagulation early ― within 4 days of the stroke ― was associated with fewer infarcts being detected by imaging at 1 month, and there was no difference in hemorrhage rate compared with starting anticoagulation later, a new study has shown.
The ATTUNE study was presented at the 14th World Stroke Congress (WSC) 2022 in Singapore on October 29 by Angelos Sharobeam, MD, University of Melbourne, Australia.
"Our results in patients with mild to moderate strokes with AF suggest that both safety and efficacy favor early commencement of anticoagulation after stroke or transient ischemic attack, and there is no justification to delaying anticoagulation to potentially reduce hemorrhage risk," Sharobeam concluded.
"Early anticoagulation also has the practical advantage of initiation during the inpatient stay after stroke, which may lead to greater anticoagulation uptake, as well as potentially earlier hospital discharge," he added.
"This study helps determine when to start anticoagulation in patients who are known to have AF after a stroke. These patients either have AF that was preexisting or was diagnosed on admission," Sharobeam told theheart.org | Medscape Cardiology.
"When to start anticoagulation in these patients after an acute ischemic stroke is an area of controversy."
