Paciaroni M, et al. - In this case-control study involving 713 cases and 700 controls, researchers identified the pathogenesis and risk factors for cerebrovascular ischemic events seen during non-vitamin K antagonist oral anticoagulants (NOACs) treatment for stroke prevention in patients with atrial fibrillation (AF). Off-label low dose, atrial enlargement, hyperlipidemia, and high CHA₂DS₂-VASc score were linked to increased risk of cerebrovascular events in patients with AF treated with NOACs who had a cerebrovascular event, mostly but not exclusively of cardioembolic pathogenesis. Among the components of CHA₂DS₂-VASc, age was older and the presence of diabetes mellitus, congestive heart failure, and stroke history or transient ischemic attack was more common in patients with acute cerebrovascular ischemic events.