Abstract WP144: Early Initiation of Anticoagulation is Safe After Ischemic Stroke With Atrial Fibrillation, Meta-Analysis and Systemic Review
Bibliographic record
Abstract
Background: Large randomized clinical trials have established the superiority of Direct oral anticoagulants (DOACs) over Vitamin-K antagonists in atrial fibrillation (AF) related to Acute Ischemic stroke (AIS). However, the data regarding outcomes of early versus late administration of DOACs is limited, but few recent studies & clinical trials provided some evidence. Methodology: The Preferred Reporting Items for Systematic Reviews & Meta-Analyses (PRISMA) standards were followed for this systematic review & meta-analysis". Our search strategy used the Population (AF-related AIS patients taking DOACs), Intervention (early anticoagulation; before 3-4 days), Comparison (late anticoagulation; after 3-4 days), Outcomes & Study type (PICOS) question format. The outcomes of interest were Intracranial hemorrhage (ICH), ischemic stroke & all-cause mortality. The data was pooled using Mantel-Haenszel random effect model & the Higgins I 2 test was used to determine the heterogeneity in each analysis. Results: After the database search & study screening, we included 3 prospective cohorts & 1 RCT in our review. All four eligible studies were of good quality (the Newcastle Ottawa Scale & Cochrane Risk of Bias tool 2). Of the 1831 patients who received DOACs in A-F related AIS, 966 were given before 3-4 days & 865 people received them after 3-4 days. The adverse event of ICH (RR 0.65 [95% CI: 0.41 - 1.01] p = 0.68, I 2 = 0%) was similar in both early & late groups. No significant difference in Risk of Ischemic stroke (RR 0.67 [95% CI: 0.36 - 1.24] p = 0.28, I 2 = 22%) & all-cause mortality (RR 0.72 [95% CI: 0.45 - 1.17] p = 0.52, I 2 = 0%) was noted between the two groups. Conclusion: Our meta-analysis found that initiating DOACs within 3-4 days of AF-associated stroke is safe & does not affect outcomes such as ICH incidence, stroke recurrence, or all-cause mortality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.064 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.024 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".