A survey of opinion: When to start oral anticoagulants in patients with acute ischaemic stroke and atrial fibrillation?

Munn, D., Abdul-Rahim, A., Fischer, U., Werring, D. J., Robinson, T. G. and Dawson, J. (2018) A survey of opinion: When to start oral anticoagulants in patients with acute ischaemic stroke and atrial fibrillation? European Stroke Journal, 3(4), pp. 355-360. (doi:10.1177/2396987318787124)

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Abstract

Background: There is uncertainty regarding the optimal timing for initiation of oral anticoagulant treatment (OAC) in patients with recent ischaemic stroke and atrial fibrillation (AF). We surveyed the current UK practice and assessed clinician’s opinions of when to use OAC in recent stroke patients with AF. Methods: An online survey was sent to stroke physicians within the United Kingdom via their national societies. Results: One hundred and twenty-one clinicians responded to the survey. Ninety-five percent of responders agreed there was uncertainty regarding timing of OAC initiation after AF-related ischaemic stroke. Thirty-six percent of responders followed the ‘1-3-6-12’ European Society of Cardiology (ESC) guidelines recommendation. Uncertainty was greater in cases of moderate stroke than in cases of TIA, mild or severe stroke. Eighty-eight percent of responders would be willing to participate in a clinical trial of early vs. later initiation of OAC after stroke. Direct-acting oral anticoagulant (DOAC) were the preferred OAC of choice. Conclusion: There is a lack of consensus amongst stroke physicians for when to initiate OAC to prevent recurrence in stroke patients with AF. There is little uncertainty regarding TIA. A clinical trial assessing use of early vs. later initiation of DOAC in patients with recent ischaemic stroke and AF would be beneficial.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Abdul-Rahim, Dr Azmil and Dawson, Professor Jesse
Authors: Munn, D., Abdul-Rahim, A., Fischer, U., Werring, D. J., Robinson, T. G., and Dawson, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
Journal Name:European Stroke Journal
Publisher:SAGE Publications
ISSN:2396-9873
ISSN (Online):2396-9881
Published Online:10 July 2018
Copyright Holders:Copyright © 2018 European Stroke Organisation
First Published:First published in European Stroke Journal 3(4): 355-360
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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