{'fraction_non_alphanumeric': 0.02349336057201226, 'fraction_numerical': 0.005107252298263534, 'mean_word_length': 4.9393939393939394, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 2, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
How long should we wait to start oral anticoagulation after cardioembolic stroke?

As a neurology resident many years ago, I carried in the pocket of my white coat a small notebook. I used this as a quick reference guide, recording the diagnostic and treatment recommendations of the neurology professors training me. I still have the book, and occasionally amuse myself by perusing the entry for acute stroke, satisfying in its pure simplicity: “If Afib present > start IV heparin; if no Afib > start aspirin.” As is so often the case, clinical trial data soon enough proved this received wisdom wrong. In the Heparin in Acute Embolic Stroke Trial, which enrolled patients with stroke and atrial fibrillation, a low-molecular-weight heparin started within 30 hours of stroke onset showed no benefit compared to aspirin.1 Similar lack of benefit for acute parenteral anticoagulation for stroke caused by atrial fibrillation was seen in subgroup analyses of other large trials.2,3