Study Finds Stroke Patients Can Start Anticoagulation Earlier Than Once Thought

A new global study published in The Lancet found that “starting blood thinners within four days of an ischemic stroke caused by atrial fibrillation can significantly lower the risk of a second stroke.”

The question of when to begin blood-thinning medication after a stroke has long puzzled clinicians out of fear that beginning it too early may increase the risk of brain bleeding.

The study analyzed data from “more than 5,400 patients across four major randomized clinical trials.” Steven Warach, co-author of the study, says that the results provide “the clearest evidence yet that in most cases, it’s not only safe to start [anticoagulation] earlier – it’s better for patients.”

The results showed that “starting DOACs within four days of stroke onset cut the risk of a second stroke by nearly one-third” with “no added risk of brain bleeding or other major complications.” This suggests that “earlier DOAC use should become the new standard of care,” as it has the “potential to shorten hospital stays and improve global outcomes.”

Atrial fibrillation is an “irregular heartbeat that increases stroke risk, [causing] about 1 in 3 ischemic strokes.” Most physicians historically have waited one to two weeks to begin treatment with DOACs despite their effectiveness in preventing future strokes.