What are the recommendations for anticoagulation in AF patients with acute ischemic stroke?
In AF patients with acute stroke without contraindications, we recommend that long-term oral anticoagulation is indicated as secondary prevention (Strong recommendation, high quality evidence). In AF patients with acute ischemic stroke, we suggest that oral anticoagulation should usually be started within 2 weeks of acute ischemic stroke, but the optimal timing within this period is not known (Ungraded consensus-based statement). In patients with AF and high ischemic stroke risk, we suggest anticoagulation with an NOAC after acute spontaneous ICH (which includes subdural, subarachnoid, and intracerebral hemorrhages) after careful consideration of the risks and benefits (Ungraded consensus-based statement).