45
4.9. Anticoagulants
COR LOE
Recommendations
2a A
1. (New and of High Impact) In carefully selected (eg,
milder severity) patients with AIS with atrial fibrillation,
a strateg y of early oral anticoagulation poststroke is low
risk and is reasonable compared with a strateg y of delayed
anticoagulation, although the efficacy of early anticoagulation
for prevention of early recurrent stroke is not established.
2b B-NR
2. In patients with an AIS and ipsilateral, high-grade ICA stenosis,
the benefit of urgent anticoagulation is not well established.
2b C-LD
3. In patients with AIS with an ipsilateral, nonocclusive,
extracranial intraluminal thrombus, the safety and efficacy of
short-term anticoagulation are not well established.
3: No
benefit
C-LD
4. In patients with AIS who experience HT, initiation or
continuation of anticoagulation may be considered depending
on the specific clinical scenario and underlying indication.
3: No
benefit
A
5. In patients with AIS, the use of argatroban is not effective
as an adjunctive therapy with IVT to improve long-term
functional outcomes.
3: No
benefit
A
6. In patients with AIS, early anticoagulation (within 48
hours of stroke onset) does not reduce the likelihood of
early neurological worsening or increase the likelihood of a
favorable functional outcome and is not recommended.
