Q&A with Dr. Paciaroni
Stroke Progress and Innovation Awards 2015
Maurizio Paciaroni, MD
Maurizio Paciaroni, Giancarlo Agnelli, Nicola Falocci, Valeria Caso, Cecilia Becattini, Simona Marcheselli, Christina Rueckert, Alessandro Pezzini, Loris Poli, Alessandro Padovani, Laszló Csiba, Lilla Szabó, Sung-Il Sohn, Tiziana Tassinari, Azmil H. Abdul-Rahim, Patrik Michel, Maria Cordier, Peter Vanacker, Suzette Remillard, Andrea Alberti, Michele Venti, Umberto Scoditti, Licia Denti, Giovanni Orlandi, Alberto Chiti, Gino Gialdini, Paolo Bovi, Monica Carletti, Alberto Rigatelli, Jukka Putaala, Turgut Tatlisumak, Luca Masotti, Gianni Lorenzini, Rossana Tassi, Francesca Guideri, Giuseppe Martini, Georgios Tsivgoulis, Kostantinos Vadikolias, Chrissoula Liantinioti, Francesco Corea, Massimo Del Sette, Walter Ageno, Maria Luisa De Lodovici, Giorgio Bono, Antonio Baldi, Sebastiano D’Anna, Simona Sacco, Antonio Carolei, Cindy Tiseo, Monica Acciarresi, Cataldo D’Amore, Davide Imberti, Dorjan Zabzuni, Boris Doronin, Vera Volodina, Domenico Consoli, Franco Galati, Alessio Pieroni, Danilo Toni, Serena Monaco, Mario Maimone Baronello, Kristian Barlinn, Lars-Peder Pallesen, Jessica Kepplinger, Ulf Bodechtel, Johannes Gerber, Dirk Deleu, Gayane Melikyan, Faisal Ibrahim, Naveed Akhtar, Maria Giulia Mosconi, Valentina Bubba, Ilenia Silvestri, and Kennedy R. Lees
SPOTLIGHT: Q&A with Dr. Paciaroni
What is the key take-away message from your article?
The RAF study seems to indicate that the best time for initiating anticoagulation treatment for secondary stroke prevention in patients with acute stroke and atrial fibrillation is 4-14 days from stroke onset. Moreover, the decision to initiate anticoagulant therapy earlier within this range should depend on the ischemic lesion size. That is, the smaller size, the earlier the treatment should begin. Finally, in the same patients, it seems to be recommendable the initiation of oral anticoagulants alone, instead of either low molecular weight heparins alone or before oral anticoagulants.
What prompted you and your co-authors to perform this study?
After several years of clinical practice, we realized that this was a serious problem and it had not been investigated in the literature.
What is innovative about this work? And what are its applications?
Regarding its applications, we would like to have a larger randomized study performed, in order to confirm partially or fully our results. Concerning the innovative aspect, the study design included numerous centers, and statistical approach included the estimates of both risk of stroke recurrence and risk of hemorrhagic transformation associated with the time of initiating anticoagulant treatment.
Tell us about the biggest challenge you came across while conducting this study.
As with all successful studies, the challenges lie in its initial steps. Specifically, a meticulous and well thought out design must be crafted.
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