Atrial fibrillation (AF) has a lifetime risk of 1 in 4 in European populations, and increases the risk of ischaemic stroke 4-5 fold. About 1 in 5 strokes are caused by AF (over 20,000 strokes per year in the UK). In AF- associated acute ischaemic stroke, the risk of early recurrence (within 7-14 days) is high, between 0.4% and 1.3% per day.
AF-associated ischaemic strokes are more often disabling or fatal than other types of stroke, with
longer hospital stays and higher costs, so preventing early recurrence is a key clinical challenge.
Direct Oral Anti-Coagulants might allow safe and earlier clot-busting after acute ischaemic stroke in patients with AF, providing net benefit by reducing ischaemic stroke recurrence without increased risk of bleeding into the brain. The OPTIMAS clinical trial aims to test this hypothesis.