When do you restart anticoagulation in patients with atrial fibrillation who just had an ischemic stroke?
Would you change your practice in light of the recently published CATALYST metanalysis?
Answer from: at Academic Institution
The recent ELAN trial (Fischer et al., PMID 37222476) and now the published CATALYST meta-analysis (Dehbi et al., PMID 40570866) all support the concept that early anticoagulation (within 4 days of stroke) with a DOAC is safe and effective. There appears to be no interaction with clinical factors su...
The timing of when to resume anticoagulation depends on the individual aspects of the case, with infarct size being one of the main determinants. The older clinical trials showed no benefit from early anticoagulation after an acute cardioembolic ischemic stroke but an increase in the risk of hemorrh...