The pros and cons of early vs late initiation of direct OAC after acute ischemic stroke in the setting of AF for secondary prevention, was the topic of a lively debate at the EAN Congress.
HELSINKI, Finland — The pros and cons of early vs late initiation of a direct oral anticoagulant after acuteIn an audience vote prior to the discussion, 77% voted yes to early anticoagulation, whereas 23% opted for no early anticoagulation.
Opposing Fischer was Zuzana Gdovinova, MD, PhD, Department of Neurology, L. Pasteur University Hospital, P.J. Safarik University, Kosice, Slovakia. Session Chair Anita Arsovska, MD, PhD, head of Department for Urgent Neurology, University Clinic of Neurology, and professor of neurology at University Ss Cyril and Methodius, Skopje, North Macedonia, agreed and endorsed the idea of an individualized approach.
Numerically lower rates of ischemic stroke and death and the absence of symptomatic ICH suggests that early OAC initiation was safe and should be considered for acute secondary. This study included just over 2000 patients with an acute ischemic stroke and AF. So the next question is whether the drive for early OAC could be pushed to as early as within 48 hours of a major stroke. Regarding the timing of restarting OAC after hemorrhage, his group has done more work on this, which will soon be published inThe goal of this study was to assess whether the presence of HT on pre-randomization imaging in the ELAN study modified the estimated safety of early vs late initiation of OAC.
He concluded his talk by detailing several other randomized controlled trials that are ongoing or are completed but are still to report investigating stroke prevention in patients with AF and a history of ICH. These include: NASPAF-ICH, ENRICH-AF, ASPIRE, PRESTIGE-AF, STATICH, A3ICH, and STROKECLOSE. Gdovinova then took podium and said that treating minor or moderate stroke is not the issue, rather, she added,"the fear of bleeding is in major stroke.
Turning to current guidelines, Gdovinova noted that the European Heart Rhythm Association recommends starting OAC after 12 or 14 days in major stroke. The 2020 European Society of Cardiology from the European Stroke Organisation "because of the low quality of evidence"; ESO recommends initiating OAC treatment after 14 days in patients with major ischemic stroke, she noted.
However, another observational study from the Swedish Registry recommended that the best time to start oral anticoagulation in this group of patients is between 7 and 8 weeks after brain hemorrhage.
Cerebrovascular Accident CVA - Cerebrovascular Accident Thromboembolism Anticoagulation Therapy Anticoagulant Anticoagulation Atrial Fibrillation AF Afib A-Fib Afib Afib Atrial Fib Atrial Fibrillation (AF) Atrial Fibrillation (A-Fib) AF - Atrial Fibrillation Ischemic Stroke Ischaemic Stroke Brain Hemorrhage Brain Bleeding Brain Haemorrhage Brain Hemorrhage Bleeding
United States Latest News, United States Headlines
Similar News:You can also read news stories similar to this one that we have collected from other news sources.
Running Archive Full Node for Blockchain Devs: Pros and ConsHere's why modern decentralized applications require archive full nodes - and what it takes to run one
Read more »
A Face-lift: One Beauty Expert Weighs the Pros and ConsIf a face-lift will make you happy and you can afford it, then go for it; it’s a practical way to provide yourself with a temporary happiness fix.
Read more »
That's the ticket: Pros and cons of top contenders to be Donald Trump's V.P.Former President Donald Trump has a list of political heavyweights and conservative stars to choose from for a running mate, but he says he has zeroed in on the V.P. pick he'll announce at the Republican National Convention in July.
Read more »
The pros and cons of using sleep supplementsFrom insomnia to restless leg syndrome to sleep apnea – more than 50 million Americans suffer from sleep disorders.
Read more »
31 Products With Tons Of Pros And Pretty Much No ConsI'm sorry, but you literally cannot find fault with a three-pack of sunnies under $20.
Read more »
FEMA flood insurance: Comparing the pros and cons of flood insurance optionsWhat's right for you? Private insurance v. FEMA flood insurance
Read more »