{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:49:22Z","timestamp":1793260162981,"version":"4.5.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Evidence to guide the optimal timing of antiplatelet and oral anticoagulants (OACs) therapy after hemorrhagic infarction (HI) versus parenchymal hematoma (PH) is limited and inconsistent, leading to substantial variation in practice. This study's goal was to study the practice pattern and compare clinical outcomes associated with early\u2010versus\u2010delayed initiation of antiplatelet\/OACs after hemorrhagic transformation (HT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This multicenter, retrospective, cross\u2010sectional study included patients with acute ischemic stroke and HT. Patients with an HI or PH were categorized by HT to antithrombotic initiation time, and their outcomes\u201430\u2010day HT exacerbation, composite outcomes of recurrent stroke\/systemic emboli, 90\u2010day vascular death, and functional outcomes\u2014were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Of 748 patients, 496 received antiplatelets, and 252 received OACs after HT. The median HT\u2010to\u2010antiplatelet time was significantly shorter after HI than PH (1 [interquartile range, 0\u20132] versus 3 [interquartile range, 1\u20135] days;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). There were no statistically significant differences in HT exacerbation and composite outcomes (30\u2010day), as well as vascular death and unfavorable functional outcomes (90\u2010day), between patients who received same\u2010day, early (HI, &lt;1 day; PH, &lt;3\u2009days), or late (HI, &gt;1 day; PH, &gt;3\u2009days) antiplatelets after either HI or PH. Among patients on OACs, those with HI had shorter median HT\u2010to\u2010OAC time than PH (7 [interquartile range, 2\u201315] versus 15 [interquartile range, 7\u201332] days;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Although HT exacerbation rates (30\u2010day) were comparable between early (HI, &lt;7\u2009days; PH, &lt;15\u2009days) and late (HI, &gt;7\u2009days; PH, &gt;15\u2009days) OAC initiation after either HI or PH, late initiation after PH was accompanied by higher rates of composite outcomes (30\u2010day) than early initiation (20.7% versus 3%;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.044). Regression models adjusted for demographics, National Institutes of Health Stroke Scale, and stroke severity showed no statistically significant association between early initiation of antiplatelets or OACs with HT exacerbation risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Our study found no statistically significant difference in HT exacerbation between early and late initiation of antiplatelets or OACs among patients with HI\/PH, while prolonged delay among patients with PH were accompanied by increased systemic thromboembolic events. Although these findings offer preliminary clinical insight, prospective studies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045634","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:22:32Z","timestamp":1783074152000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Timing of Antithrombotic Therapy Among Patients With Hemorrhagic Transformation After an Ischemic Stroke"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8448-1539","authenticated-orcid":false,"given":"Seyyed Sina","family":"Hejazian","sequence":"first","affiliation":[{"name":"Pennsylvania State University","place":["Hershey, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2116-9492","authenticated-orcid":false,"given":"Shima","family":"Shahjouei","sequence":"additional","affiliation":[{"name":"Penn State Health Milton S. Hershey Medical Center","place":["Hershey, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4447-501X","authenticated-orcid":false,"given":"Sasan","family":"Bahrami","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5603-1732","authenticated-orcid":false,"given":"Ajith","family":"Vemuri","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2033-449X","authenticated-orcid":false,"given":"Oana M.","family":"Dumitrascu","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine","place":["Phoenix, 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