In a nutshell
This study investigated whether anticoagulants were effective at preventing second stroke in patients with atrial fibrillation, and when treatment should be started. They concluded that anticoagulants are more effective than antiplatelets, and are most effective when administered between 4 and 14 days after the first stroke.
Some background
Atrial fibrillation (AF) is a heart problem where the rhythm of the heart is irregular. It is common in ischemic stroke patients (blocked blood vessel stops blood flow to the brain). Stroke patients who develop AF are at a higher risk of a second stroke. Prevention methods include treating patients with anticoagulant drugs, which stop the blood from clotting. The optimal time for administering these drug is not clear.
Methods & findings
This study aimed to assess how soon after stroke AF stroke patients should begin taking anticoagulant drugs.
1029 people were included in the study. 317 of these were treated with anticoagulants, with 449 treated with antiplatelets (another type of blood thinner) before anticoagulants. 231 were treated with antiplatelets alone and 32 patients received no drugs at all.
Out of the total 1029 patients, 77 patients had a stroke. 51 patients experienced bleeding in the brain. 11.7% of these patients had been treated with anticoagulants, 14.4% did not receive anticoagulants.
Patients who began anticoagulant treatment between 4-14 days after stroke had the lowest risk of a secondary stroke.
The bottom line
This study concluded that anticoagulants appear more effective than antiplatelet drugs in preventing recurrent stroke. Anticoagulants administered to stroke patients with AF 4-14 days after stroke gives the lowest risk of secondary stroke.
The fine print
Patients were not randomly picked to be treated with either anticoagulants or antiplatelets, so this suggests a selection bias.
Published By :
Stroke
Date :
Jun 30, 2015
