Pana TA, et al. - In this prospective hospital register cohort study with 10,816 patients (mean age±SD =77.9±12.1 years), researchers assessed how acute ischemic stroke outcomes (in-hospital mortality, length-of-stay, poststroke disability, long-term mortality, and stroke recurrence) were influenced by individual and combined effects of atrial fibrillation (AF) and heart failure (HF). Between 2004 and 2016, subjects with acute ischemic stroke admitted to a UK center with a population of ≈900 000 were included. Independent of comorbid HF, an excess risk of stroke recurrence was linked to AF. In addition, HF without AF was linked to a significant risk of recurrence. In patients with HF without AF, anticoagulation for secondary stroke prevention may require further assessment in a clinical trial setting.