Experts Debate Pros and Cons of Early OAC in Severe Stroke

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At the Congress of the European Academy of Neurology 2024, experts debated the pros and cons of early vs late initiation of anticoagulants after an acute ischemic stroke in patients with atrial fibrillation. The majority favored early anticoagulation to prevent recurrent ischemic strokes, despite the risk of hemorrhagic transformation. Different studies, such as TIMING and ELAN, supported the safety and efficacy of early initiation of anticoagulation. However, there are still questions about when to start anticoagulation in severe stroke cases and how to manage patients with hemorrhagic transformation. Individualized approaches based on patient characteristics and risks were suggested to guide treatment decisions.

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