Comparison of early and delayed anticoagulation therapy after ischemic stroke in patients with atrial fibrillation: a systematic review and meta-analysis

Jiang, Mengjin; Wang, Congyao; Zhang, Yaodong

doi:10.1007/s11239-023-02872-0

Cited by 5 publications

(1 citation statement)

References 34 publications

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“…The TIMING trial found that early initiation (≤ 4 days) was not inferior to delayed onset (5-10 days) of DOAC after acute ischemic stroke and early initiation was safe due to the absence of symptomatic ICH [ 138 ]. The ELAN trial and a subsequent meta-analysis also suggested that it was safe to start DOAC therapy early compared with delayed initiation [ 139 , 141 ]. A recent analysis of the PRODAST study included 3312 patients with acute IS or transient ischemic attack (TIA) who were treated with dabigatran or VKA and indicated that the early (≤ 7 days) initiation of dabigatran seemed to be safer and superior than VKA initiated at any time with regards to the risk of ICH [ 142 ].…”

Section: Resumption Of Anticoagulants In Aaichmentioning

confidence: 99%

Reversal and resumption of anticoagulants in patients with anticoagulant-associated intracerebral hemorrhage

Yang,

Jing,

Chen

et al. 2024

Eur J Med Res

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The use of anticoagulants has become more frequent due to the progressive aging population and increased thromboembolic events. Consequently, the proportion of anticoagulant-associated intracerebral hemorrhage (AAICH) in stroke patients is gradually increasing. Compared with intracerebral hemorrhage (ICH) patients without coagulopathy, patients with AAICH may have larger hematomas, worse prognoses, and higher mortality. Given the need for anticoagulant reversal and resumption, the management of AAICH differs from that of conventional medical or surgical treatments for ICH, and it is more specific. Understanding the pharmacology of anticoagulants and identifying agents that can reverse their effects in the early stages are crucial for treating life-threatening AAICH. When patients transition beyond the acute phase and their vital signs stabilize, it is important to consider resuming anticoagulants at the right time to prevent the occurrence of further thromboembolism. However, the timing and strategy for reversing and resuming anticoagulants are still in a dilemma. Herein, we summarize the important clinical studies, reviews, and related guidelines published in the past few years that focus on the reversal and resumption of anticoagulants in AAICH patients to help implement decisive diagnosis and treatment strategies in the clinical setting.

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