Abstract 435: Timing of Anticoagulation Therapy After Ischemic Stroke: Comparative Outcomes in Early vs. Late Treatment Strategies

Introduction The optimal timing for initiating anticoagulation therapy in patients with atrial fibrillation (AF) after an ischemic stroke remains a topic of ongoing debate. This study aims to compare the cognitive and functional outcomes of early versus late initiation of anticoagulation therapy in stroke patients with AF, providing insights into the potential benefits of timely intervention. Methods We conducted a retrospective analysis of 300 ischemic stroke patients with confirmed AF who received anticoagulation therapy. Patients were categorized into two groups based on the timing of therapy initiation: the early treatment group, where anticoagulation was started within 24 hours post‐stroke, and the late treatment group, where therapy was initiated beyond 24 hours. Cognitive recovery was assessed using the Montreal Cognitive Assessment (MoCA) six months post‐stroke, and functional outcomes were evaluated using the Activities of Daily Living (ADL) scale. Results The analysis revealed that patients who received early anticoagulation therapy demonstrated significantly better cognitive outcomes compared to those in the late treatment group. Specifically, MoCA scores were higher in the early group (24.5 ± 3.5 vs. 21.8 ± 4.0, p < 0.01), indicating enhanced cognitive recovery. Additionally, functional assessments showed that patients in the early treatment group had superior ADL scores, reflecting better functional independence six months post‐stroke. Conclusion Our findings suggest that early initiation of anticoagulation therapy in stroke patients with AF is associated with more favorable cognitive and functional outcomes compared to delayed treatment. The results underscore the importance of timely intervention in improving recovery trajectories for stroke patients at risk of AF‐related complications. These insights highlight the potential benefits of early anticoagulation in enhancing post‐stroke recovery, offering a compelling argument for revisiting current clinical guidelines on the timing of anticoagulation therapy in this patient population.