Trial reportCirculation2022
Early Versus Delayed Non-Vitamin K Antagonist Oral Anticoagulant Therapy After Acute Ischemic Stroke in Atrial Fibrillation (TIMING): A Registry-Based Randomized Controlled Noninferiority Study.
Trial report in Circulation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT02961348 (Timing of Oral Anticoagulant Therapy in Acute Ischemic Stroke With Atrial Fibrillation), which is not on this map. Cited by 92 papers, 6 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.
Timing of Oral Anticoagulant Therapy in Acute Ischemic Stroke With Atrial Fibrillation: a Prospective Multicenter Registry-based Non-inferiority Randomized Controlled Clinical Trial
Who cites it
92 citing papers in PubMed, 6 syntheses or guidelines pooled it, 160 citations in OpenAlex.
- Early versus late oral anticoagulants after acute ischemic stroke in atrial fibrillation patients: a meta-analysis of randomized controlled trials.Proceedings (Baylor University. Medical Center) · 2026Pooled it
- Early versus late anticoagulation treatment after acute ischemic stroke with atrial fibrillation: a meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- Comparison of early vs late anticoagulation for secondary stroke prevention in patients with atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.Journal of thrombosis and thrombolysis · 2025Pooled it
- 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
- Early versus delayed anticoagulation in acute ischemic stroke with atrial fibrillation according to infarct volume and location: A prespecified subgroup analysis of the OPTIMAS randomized controlled trial.International journal of stroke : official journal of the International Stroke Society · 2026Trial
- Net Benefit of Early Anticoagulation for Stroke With Atrial Fibrillation: Post Hoc Analysis of the ELAN Randomized Clinical Trial.JAMA network open · 2025Trial
- Outcomes of patients with atrial fibrillation and ischemic stroke while on oral anticoagulation.European heart journal · 2023Trial
- A Transient Left Atrial Appendage Filling Defect During Anticoagulation Interruption After Ischemic Stroke with Progressive Hemorrhagic Transformation: A Case Report.Reports (MDPI) · 2026Article
- Article
- Atrial fibrillation detected after stroke: Recent advances and future directions.International journal of stroke : official journal of the International Stroke Society · 2026Review
- Timing of Antithrombotic Therapy Among Patients With Hemorrhagic Transformation After an Ischemic Stroke.Journal of the American Heart Association · 2026Article
- Effectiveness of Nurse-Led atrial Fibrillation Detection for Patients With Embolic Stroke of Unknown Source in Stroke Units: A Retrospective Study.Nursing in critical care · 2026Article
- Construction and Validation of a 90-Day Mortality Risk Prediction Model Based on Interpretable Machine Learning for Acute Ischemic Stroke Patients Undergoing Mechanical Thrombectomy.Journal of clinical medicine · 2026Article
- Early versus late anticoagulation on outcomes in large hemispheric infarction: a propensity score-matched analysis.Journal of neurology · 2026Article
- Early Anticoagulation in Acute Ischemic Stroke With Atrial Fibrillation.Journal of stroke · 2026Review
- Outcomes of Early Versus Later Anticoagulation in Asian Atrial Fibrillation-Related Stroke: ELAN Subgroup Analysis.Journal of stroke · 2026Article
- Breakthrough Stroke in Women With Atrial Fibrillation: A Call for Sex-Specific Care and Better Outcomes.Journal of the American Heart Association · 2026Article
- Temporary Discontinuation and Restarting of Oral Anticoagulants for Neurological and Cardiac Indications.Deutsches Arzteblatt international · 2026Review
32 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are no evidence-based recommendations on the optimal time point to initiate non-vitamin K antagonist oral anticoagulants (NOACs) after acute ischemic stroke in patients with atrial fibrillation. We aimed to investigate the efficacy and safety of early versus delayed initiation of NOAC in these patients.
methodsTIMING (Timing of Oral Anticoagulant Therapy in Acute Ischemic Stroke With Atrial Fibrillation) was a registry-based, randomized, noninferiority, open-label, blinded end-point study at 34 stroke units using the Swedish Stroke Register for enrollment and follow-up. Within 72 hours from stroke onset, patients were randomized to early (≤4 days) or delayed (5-10 days) NOAC initiation, with choice of NOAC at the investigators' discretion. The primary outcome was the composite of recurrent ischemic stroke, symptomatic intracerebral hemorrhage, or all-cause mortality at 90 days. The prespecified noninferiority margin was 3%. Secondary outcomes included the individual components of the primary outcome.
resultsBetween April 2, 2017, and December 30, 2020, 888 patients were randomized to either early (n=450) or delayed (n=438) initiation of NOAC. No patient was lost to 90-day follow-up. Mean age was 78.3 years (SD, 9.9 years); 46.2% were women; 49.1% had previously known atrial fibrillation; and 17.5% prior stroke. The primary outcome occurred in 31 patients (6.89%) assigned to early initiation and in 38 patients (8.68%) assigned to delayed NOAC initiation (absolute risk difference, -1.79% [95% CI, -5.31% to 1.74%];
conclusionsEarly initiation was noninferior to delayed start of NOAC after acute ischemic stroke in patients with atrial fibrillation. Numerically lower rates of ischemic stroke and death and the absence of symptomatic intracerebral hemorrhages implied that the early start of NOAC was safe and should be considered for acute secondary stroke prevention in patients eligible for NOAC treatment. REGISTRATION: URL: http://www. CLINICALTRIALS: gov; Unique identifier: NCT02961348.
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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.