Stroke patients with atrial fibrillation (Afib) can start taking anticoagulants, or blood thinners, sooner than previously thought, when indicated. This could reduce future strokes without increasing the risk of bleeding, researchers from University Hospital Bern in Switzerland found.
The team looked at just over 2,000 people in stroke units from 15 countries between 2017 and 2022. Based on how severe their stroke was, participants were randomly assigned to begin blood thinners earlier or later than guidelines recommend.
Those who started earlier went on the drugs within 48 hours after a mild or moderate stroke, or on day 6 or 7 after a major stroke. Participants going on medications later than the norm started 3 to 4 days after a mild stroke, 6 to 7 days after a moderate stroke, or 12 to 14 days after a major stroke.
At 30 days after the initial stroke, 2.9% who took the medications earlier and 4.1% who took it later had recurrent stroke, systemic embolism, major extracranial bleeding, symptomatic intracranial hemorrhage or vascular death. Of those treated early, 1.4% went on to have a recurrent stroke at 30 days, while 2.5% of those treated later had the same. In both groups 0.2% had symptomatic intracranial hemorrhage by 30 days. At 90 days, 1.9% in the early-treatment group had another stroke, while 3.1% who took the drugs later did.
The researchers say chances of having another stroke is likely lower if some patients start anticoagulants earlier rather than later.
The report appeared in The New England Journal of Medicine.
