Key points from article :
Starting blood-thinning drugs earlier than usual for people with atrial fibrillation (AF) who have had a stroke may significantly reduce their risk of experiencing another stroke, according to new research presented at the World Stroke Congress 2024. This condition, characterized by an irregular heartbeat, affects over 1.6 million people in the UK and dramatically increases stroke risk. Current guidelines suggest waiting at least five days before starting anticoagulants after a stroke due to the potential for brain bleeds. However, the findings of two studies indicate that initiating treatment sooner could be both safe and beneficial.
In a large-scale meta-analysis led by an international research team, over 5,000 patients were evaluated to compare outcomes of early (within four days) versus delayed (five days or later) blood-thinner administration after a stroke. Patients who received early anticoagulant therapy had a 35% lower chance of a repeat stroke within 30 days compared to those who started treatment later, without an increased risk of brain bleeding. A separate UK-based study, funded by the British Heart Foundation and published in The Lancet, reviewed data from 3,621 patients and similarly found that early anticoagulant use did not increase the likelihood of a brain bleed, even for those with more severe strokes.
David Werring, a clinical neurology professor at University College London and one of the lead researchers, emphasized the potential population-level benefits, estimating that earlier blood-thinning treatment could help prevent up to 200 strokes annually among the estimated 20,000 UK patients with AF who suffer a stroke each year. These findings, praised by British Heart Foundation’s Prof Bryan Williams, support a shift toward earlier anticoagulant use for AF stroke patients, which could lead to fewer secondary strokes and associated complications.
