{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T06:05:33Z","timestamp":1780380333741,"version":"3.54.1"},"reference-count":23,"publisher":"Korean Stroke Society","issue":"2","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["32003B_197009"],"award-info":[{"award-number":["32003B_197009"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["32003B_169975"],"award-info":[{"award-number":["32003B_169975"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Swiss Heart Foundation"},{"name":"Stroke Association in the United Kingdom","award":["2017\/02"],"award-info":[{"award-number":["2017\/02"]}]},{"DOI":"10.13039\/100016924","name":"National Cerebral and Cardiovascular Center","doi-asserted-by":"publisher","award":["20-4-5"],"award-info":[{"award-number":["20-4-5"]}],"id":[{"id":"10.13039\/100016924","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swiss Academy of Medical Sciences\/Bangerter-Rhyner Foundation","award":["YTCR_13\/18"],"award-info":[{"award-number":["YTCR_13\/18"]}]}],"content-domain":{"domain":["j-stroke.org"],"crossmark-restriction":true},"short-container-title":["J Stroke"],"published-print":{"date-parts":[[2026,5,31]]},"abstract":"<jats:p>Background and Purpose We aimed to evaluate whether early versus late initiation of direct oral anticoagulant (DOAC) after acute ischemic stroke (AIS) yields different safety and efficacy outcomes in Asian versus non-Asian patients.Methods We analyzed Early versus Late initiation of direct oral Anticoagulants in post-ischaemic stroke patients with atrial fibrillatioN (ELAN) trial data from 2,013 AIS patients with atrial fibrillation (AF) randomized to early (\u226448 hours for minor\/moderate stroke, 6\u20137 days for major stroke) or late DOAC initiation (3\u20134 days for minor ischemic stroke, 6\u20137 days for moderate ischemic stroke, 12\u201314 days for major ischemic stroke). Patients were categorized by region as Asian (Japan and India) or non-Asian. The primary outcome was a composite of major extracranial bleeding, symptomatic intracranial hemorrhage (SICH), recurrent ischemic stroke, systemic embolism (SE), or vascular death at 30 days (trial registration: ClinicalTrials.gov number, NCT03148457).Results Among 1,975 patients, 245 were Asian (192 from Japan and 53 from India) and 1,730 were non-Asian. The primary outcome occurred in 6.5% of Asian patients (4.8% early vs. 8.3% late) and 3.1% of non-Asian patients (2.7% vs. 3.6%) (P&lt;0.01). Higher rates of recurrent ischemic stroke (4.1% [2.4% vs. 5.8%] vs. 1.7% [1.3% vs. 2.1%], P=0.02) and SE (2.0% [0.8% vs. 3.3%] vs. 0.5% [0.4% vs. 0.6%], P=0.02) accounted for this difference. No significant differences were observed in major extracranial bleeding, SICH, recurrent ischemic stroke, SE, or vascular death. No significant interaction was observed between region and treatment allocation.Conclusions Although Asian patients had worse baseline profiles and outcomes, treatment effects did not differ by region, supporting the generalizability of early DOAC initiation in Asian AIS patients without region-specific timing modifications.<\/jats:p>","DOI":"10.5853\/jos.2025.05848","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:10:39Z","timestamp":1780013439000},"page":"293-302","update-policy":"https:\/\/doi.org\/10.5853\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Early Versus Later Anticoagulation in Asian Atrial Fibrillation\u2013Related Stroke: ELAN Subgroup Analysis"],"prefix":"10.5853","volume":"28","author":[{"given":"Takeshi","family":"Yoshimoto","sequence":"first","affiliation":[{"name":"Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan"},{"name":"Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Japan"},{"name":"Department of Neurology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima City Hospital Organization, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P N","family":"Sylaja","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College PO, Thiruvananthapuram, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Beno\u00eet","family":"Rossel","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Iguchi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jikei University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajsrinivas","family":"Parthasarthy","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Surgery, Paras Health, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya","family":"Pamidimukkala","sequence":"additional","affiliation":[{"name":"Lalitha super Specialities Hospital, Guntur, 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