{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T21:09:23Z","timestamp":1780434563522,"version":"3.54.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>We aimed to compare outcomes of ischemic stroke patients with nonvalvular atrial fibrillation between earlier and later initiation of direct oral anticoagulants (DOACs) after stroke onset.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>From data for 1192 nonvalvular atrial fibrillation patients with acute ischemic stroke or transient ischemic attack in a prospective, multicenter, observational study, patients who started DOACs during acute hospitalization were included and divided into 2 groups according to a median day of DOAC initiation after onset. Outcomes included stroke or systemic embolism, major bleeding, and death at 3 months, as well as those at 2 years.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>DOACs were initiated during acute hospitalization in 499 patients in median 4 (interquartile range, 2\u20137) days after onset. Thus, 223 patients (median age, 74 [interquartile range, 68\u201381] years; 78 women) were assigned to the early group (\u22643 days) and 276 patients (median age, 75 [interquartile range, 69\u201382] years; 101 women) to the late (\u22654 days) group. The early group had lower baseline National Institutes of Health Stroke Scale score and smaller infarcts than the late group. The rate at which DOAC administration persisted at 2 years was 85.2% overall, excluding patients who died or were lost to follow-up. Multivariable Cox shared frailty models showed comparable hazards between the groups at 2 years for stroke or systemic embolism (hazard ratio, 0.86 [95% CI, 0.47\u20131.57]), major bleeding (hazard ratio, 1.39 [95% CI, 0.42\u20134.60]), and death (hazard ratio, 0.61 [95% CI, 0.28\u20131.33]). Outcome risks at 3 months also did not significantly differ between the groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Risks for events including stroke or systemic embolism, major bleeding, and death were comparable whether DOACs were started within 3 days or from 4 days or more after the onset of nonvalvular atrial fibrillation\u2013associated ischemic stroke or transient ischemic attack.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT01581502.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.119.028118","type":"journal-article","created":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T10:00:41Z","timestamp":1579687241000},"page":"883-891","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["Early Initiation of Direct Oral Anticoagulants After Onset of Stroke and Short- and Long-Term Outcomes of Patients With Nonvalvular Atrial Fibrillation"],"prefix":"10.1161","volume":"51","author":[{"given":"Tadataka","family":"Mizoguchi","sequence":"first","affiliation":[{"name":"From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (T.M., K. Toyoda, S.Y., M.T., M.S., M. Inoue, M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3291-5083","authenticated-orcid":false,"given":"Kanta","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan (K. Tanaka, H.Y.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunori","family":"Toyoda","sequence":"additional","affiliation":[{"name":"From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (T.M., K. Toyoda, S.Y., M.T., M.S., M. Inoue, M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohei","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (T.M., K. Toyoda, S.Y., M.T., M.S., M. Inoue, M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Itabashi","sequence":"additional","affiliation":[{"name":"Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan (R.I.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahito","family":"Takagi","sequence":"additional","affiliation":[{"name":"From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (T.M., K. Toyoda, S.Y., M.T., M.S., M. Inoue, M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Todo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kobe City Medical Center General Hospital, Japan (K.T.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Shiozawa","sequence":"additional","affiliation":[{"name":"From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (T.M., K. Toyoda, S.Y., M.T., M.S., M. Inoue, M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Yagita","sequence":"additional","affiliation":[{"name":"Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan (Y.Y.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan (T.Y., M. Ihara)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Terasaki","sequence":"additional","affiliation":[{"name":"Department of Neurology, Japanese Red Cross Kumamoto Hospital, Kumamoto (T.T.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Yamagami","sequence":"additional","affiliation":[{"name":"Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan (K. Tanaka, H.Y.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunya","family":"Takizawa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tokai University Hospital, Isehara, Japan (S.T.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Inoue","sequence":"additional","affiliation":[{"name":"From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (T.M., K. Toyoda, S.Y., M.T., M.S., M. Inoue, M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Kamiyama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan (K.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan (T.Y., M. 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