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Post-Stroke Anticoagulation Guidelines

Jul 20, 2025

Overview

This lecture reviews current evidence and guidelines regarding anticoagulation therapy after stroke, focusing on who should receive it, which agents are preferred, and optimal timing for initiation.

Stroke Etiology & Classification

  • Strokes can be ischemic (blockage) or hemorrhagic (bleed).
  • TOAST classification describes stroke causes: large artery atherosclerosis, small vessel occlusion, cardioembolic, other determined causes, and cryptogenic/ESUS.
  • ESUS (Embolic Stroke of Undetermined Source) often remains after full workup, especially in younger patients.

Indications for Anticoagulation ("Who")

  • Key indications: atrial fibrillation (AF), mechanical heart valves, left atrial/ventricular thrombus, antiphospholipid syndrome.
  • Cervical artery dissection and ESUS are not clear indications based on current evidence.
  • Reduced ejection fraction (<35%) alone is not sufficient unless a thrombus is present.

Pathophysiology & Thrombus Composition

  • "Red thrombi" (fibrin-rich, low-pressure systems) respond better to anticoagulants.
  • "White thrombi" (platelet-rich, high-pressure systems) respond better to antiplatelets.
  • Thrombus composition studies inform therapy but direct clinical ties vary.

Special Stroke Subtypes

  • Cervical artery dissection: studies show no advantage of anticoagulants over antiplatelets.
  • ESUS: Large trials (NAVIGATE-ESUS, RE-SPECT ESUS) show no benefit of anticoagulation over aspirin without identified AF.
  • Cardiac monitoring in ESUS may reveal AF, warranting anticoagulation if detected.
  • Aortic atheroma/arterial plaques prefer antiplatelets; insufficient data for routine anticoagulant use.
  • Patent foramen ovale (PFO): closure plus antiplatelets reduces recurrence in select young patients.
  • Cancer-associated stroke: stroke risk is higher, but evidence for anticoagulation is not definitive.

Preferred Agents ("What")

  • Warfarin and direct oral anticoagulants (DOACs/NOACs) are effective for AF, with DOACs showing lower intracranial hemorrhage risk.
  • DOACs include dabigatran, rivaroxaban, apixaban, edoxaban.
  • Warfarin remains effective but carries higher bleeding risk.
  • DOACs preferred for most non-valvular AF patients.

Timing of Anticoagulation ("When")

  • Early anticoagulation increases bleeding risk; timing depends on stroke size/severity.
  • European guidelines: 1 day after TIA, 3 days after mild stroke, 6 days after moderate, 12 days after severe stroke.
  • American Heart Association: anticoagulation reasonable within 4–14 days, individualized by infarct size and risk factors.
  • Delayed initiation advised after hemorrhagic transformation or large infarcts.
  • After intracerebral hemorrhage, reinitiate anticoagulation at least 4 (some suggest 6–8) weeks later.

Key Terms & Definitions

  • ESUS — Embolic Stroke of Undetermined Source: non-lacunar stroke without a clear source after workup.
  • DOACs/NOACs — Direct/Novel Oral Anticoagulants: new class of anticoagulants (e.g., apixaban, rivaroxaban).
  • TOAST Classification — System dividing stroke causes into major categories.

Action Items / Next Steps

  • Review current department protocols for post-stroke anticoagulation.
  • Stay updated on ongoing clinical trial results (e.g., OPTIMAS, ELAN).
  • Apply individualized risk assessment (stroke type/severity, imaging) when planning anticoagulation.
  • Consult cardiology or neurology for complex or borderline cases.