Evidence map›Paper›PMID 39608862›Full record

SynthesisOpen heart2024

Optimal timing of oral anticoagulation initiation in patients with acute ischaemic stroke and atrial fibrillation: a comprehensive meta-analysis and systematic review.

Aravind Dilli Babu, Sahib Singh, Asher Gorantla, Mirza Faris Ali Baig, Ram Bhutani, Harika Davuluri, Lekshminarayan Raghavakurup, Bengt Herweg

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Open heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. 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 · 2026
    Pooled it
  2. 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/Hemostasis
    Pooled it
  3. Article
  4. 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 · 2026
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Aravind Dilli BabuInternal Medicine, Sinai Hospital (LifeBridge Health), Baltimore, Maryland, USA ababu3@lifebridgehealth.org.ORCID 0009-0009-7689-3750
Sahib SinghInternal Medicine, Sinai Hospital (LifeBridge Health), Baltimore, Maryland, USA.
Asher GorantlaCardiology, SUNY Downstate Medical Center, New York City, New York, USA.
Mirza Faris Ali BaigInternal Medicine, Asante Three Rivers Medical Center, Grants Pass, Oregon, USA.
Ram BhutaniInternal Medicine, Sinai Hospital (LifeBridge Health), Baltimore, Maryland, USA.
Harika DavuluriInternal Medicine, Sinai Hospital (LifeBridge Health), Baltimore, Maryland, USA.
Lekshminarayan RaghavakurupInternal Medicine, Sinai Hospital (LifeBridge Health), Baltimore, Maryland, USA.
Bengt HerwegElectrophysiology, University of South Florida, Tampa, Florida, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The optimal timing for initiating direct oral anticoagulants (DOACs) for secondary stroke prevention in patients with atrial fibrillation and acute ischaemic stroke remains controversial due to concerns about haemorrhagic transformation. This study aimed to analyse the efficacy and safety of early versus late DOAC initiation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was conducted, searching major databases (PubMed, Embase, Cochrane Library and ClinicalTrials.gov) up to May 2024. A total of 11 studies were identified, comprising nine cohort studies (75.5% weight) and two randomised controlled trials (RCTs) (24.5% weight), involving 13 020 participants. The early DOAC group (mean initiation 3.5±1.29 days) included 6250 participants, while the late group (5.7±1.25 days) had 6770 participants. Outcome measures included recurrent ischaemic stroke (RIS), intracranial haemorrhage (ICH), systemic embolism, major haemorrhage (MH), non-major haemorrhage (NMH) and all-cause mortality. Statistical analysis using the Cochrane Review Manager calculated ORs and 95% CIs via the Mantel-Haenszel random effects model. This pooled meta-analysis revealed that the early DOAC group had lower rates of RIS (2.2% vs 2.9%, OR 0.72, 95% CI 0.52 to 0.98, p=0.04, I

Indexed as

AnticoagulantsAtrial FibrillationIschemic StrokeAdministration, OralHumansRisk AssessmentRisk FactorsSecondary PreventionTime FactorsAnticoagulantsAtrial FibrillationElectrophysiologyStroke

Identifiers

PMID39608862
PMCPMC11603680

What OpenQuestion holds

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Registered trials

None linked

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.