Stroke treatment with atrial fibrillation (AF)
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Stroke treatment with atrial fibrillation (AF). Anticoagulation is preferred over antiplatelets. Fully referenced neurology checklist.
Treatment options for first time stroke
- Anticoagulation is preferred over antiplatelets
- Non-vitamin K antagonist oral anticoagulants are preferred
Timing of anticoagulation
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Treatment of recurrent stroke whilst on anticoagulation
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Precautions when treating recurrent stroke whilst on anticoagulation
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Acronym
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References
- Klijn CJM, Paciaroni M, Berge E, et al. Antithrombotic treatment for secondary prevention of stroke and other thromboembolic events in patients with stroke or transient ischemic attack and non-valvular atrial fibrillation: A European Stroke Organisation guideline. Eur Stroke J 2019; doi.org/10.1177/2396987319841187. (Epub ahead of print).
- Lyon J, Nash PS, Ahmed N, et al. Early versus delayed anticoagulation in acute ischemic stroke according to atrial fibrillation subtype and time of diagnosis: subgroup analysis of the OPTIMAS randomized controlled trial. Stroke 2026; 57:1513-1525.
- Nash PS, Best JG, Lyon J, et al. Early versus delayed anticoagulation in acute ischemic stroke with atrial fibrillation according to infarct volume and location: a prespecified subgroup analysis of the OPTIMAS randomized controlled trial. Int J Stroke 2026 (Online ahead of print).
- Fasth O, Oldgren J, Ghukasyan Lakic T, et al. Early versus delayed DOAC after ischaemic stroke in atrial fibrillation: 1-year outcomes in the TIMING study and in concurrent practice. Eur Stroke J 2026; 11(2):aakag010.
- Stretz C, Wu TY, Wilson D, Seiffge DJ, Smith EE, Gurol ME, Yaghi S. Ischaemic stroke in anticoagulated patients with atrial fibrillation. JNNP 2021; 92:1164-1172.
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