ArticleAnnals of neurology2020
Anticoagulation Timing in Cardioembolic Stroke and Recurrent Event Risk.
Article in Annals of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Pooled it
- Comparison of early and delayed anticoagulation therapy after ischemic stroke in patients with atrial fibrillation: a systematic review and meta-analysis.Journal of thrombosis and thrombolysis · 2023Pooled it
- Anticoagulation Timing After Stroke in Atrial Fibrillation: Evidence from a Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- The optimum anticoagulation time after endovascular thrombectomy for atrial fibrillation-related large vessel occlusion stroke: a real-world study.Journal of neurology · 2023Trial
- [Prognostic analysis of anticoagulation therapy in elderly patients with cardioembolic stroke].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Article
- Optimal timing of anticoagulation after ischemic stroke in atrial fibrillation: a systematic review and network meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Research Advances in Timing of Anticoagulant Therapy Following Cardioembolic Stroke.Clinical Medicine Insights. Cardiology · 2026Review
- Early Versus Late Anticoagulation for Acute Ischemic Stroke in Atrial Fibrillation: A Systematic Review and Meta-Analysis of 17,380 Patients.Neurology international · 2025Review
- Early Anticoagulation After Large Ischemic Stroke in the Initiation of Anticoagulation After Cardioembolic Stroke Study.Journal of clinical neurology (Seoul, Korea) · 2025Article
- Optimal Timing of Oral Anticoagulant Therapy Initiation Post-acute Ischemic Stroke: A Narrative Review.Cureus · 2025Review
- Ischemic stroke prevention in patients with atrial fibrillation and a recent ischemic stroke, TIA, or intracranial hemorrhage: A World Stroke Organization (WSO) scientific statement.International journal of stroke : official journal of the International Stroke Society · 2025Review
- Long-Term Clinical Implications of High-Risk Cardiac Computed Tomography Findings in Patients With Acute Ischemic Stroke.Journal of the American Heart Association · 2024Article
- Early or late initiation of dabigatran versus vitamin-K-antagonists in acute ischemic stroke or TIA: The PRODAST study.International journal of stroke : official journal of the International Stroke Society · 2023Observational
- Contemporary Antiplatelet and Anticoagulant Therapies for Secondary Stroke Prevention: A Narrative Review of Current Literature and Guidelines.Current neurology and neuroscience reports · 2023Review
- Evaluation of the timing of using direct oral anticoagulants after ischemic stroke for patients with atrial fibrillation.Heliyon · 2023Article
- Development and refinement of diagnostic and therapeutic strategies for managing patients with cardiogenic stroke: An arduous journey.World journal of clinical cases · 2023Review
- Early Anticoagulation in Patients with Acute Ischemic Stroke Due to Atrial Fibrillation: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2022Article
- Stroke health management: Novel strategies for the prevention of recurrent ischemic stroke.Frontiers in neurology · 2022Article
- Early recurrence of ischaemic stroke of cardioembolic cause and delayed anticoagulation: a case report.Drugs in context · 2022Article
- Rationale, Design and Methods of the Prospective Record of the Use of Dabigatran in Patients with Acute Stroke or TIA (PRODAST) Study.European stroke journal · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
29 authors at 9 institutions in 1 country.
Funding
Abstract
objectiveGuidelines recommend initiating anticoagulation within 4 to 14 days after cardioembolic stroke. Data supporting this did not account for key factors potentially affecting the decision to initiate anticoagulation, such as infarct size, hemorrhagic transformation, or high-risk features on echocardiography.
methodsWe pooled data from stroke registries of 8 comprehensive stroke centers across the United States. We included consecutive patients admitted with ischemic stroke and atrial fibrillation. The primary predictor was timing of initiating anticoagulation (0-3 days, 4-14 days, or >14 days), and outcomes were recurrent stroke/transient ischemic attack/systemic embolism, symptomatic intracerebral hemorrhage (sICH), and major extracranial hemorrhage (ECH) within 90 days.
resultsAmong 2,084 patients, 1,289 met the inclusion criteria. The combined endpoint occurred in 10.1% (n = 130) subjects (87 ischemic events, 20 sICH, and 29 ECH). Overall, there was no significant difference in the composite endpoint between the 3 groups (0-3 days: 10.3%, 64/617; 4-14 days: 9.7%, 52/535; >14 days: 10.2%, 14/137; p = 0.933). In adjusted models, patients started on anticoagulation between 4 and 14 days did not have a lower rate of sICH (vs 0-3 days; odds ratio [OR] = 1.49, 95% confidence interval [CI] = 0.50-4.43), nor did they have a lower rate of recurrent ischemic events (vs >14 days; OR = 0.76, 95% CI = 0.36-1.62, p = 0.482).
interpretationIn this multicenter real-world cohort, the recommended (4-14 days) time frame to start oral anticoagulation was not associated with reduced ischemic and hemorrhagic outcomes. Randomized trials are required to determine the optimal timing of anticoagulation initiation. ANN NEUROL 2020;88:807-816.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.