A systematic review including 7 studies with a total of 4 624 subjects was abstracted in DARE. Studies comparing initial treatment (within 48 h) with anticoagulants (s.c. and i.v. unfractionated heparin, s.c. low molecular weight heparin, s.c. and i.v. heparinoids) with other treatments (placebo or aspirin) were included. Atrial fibrillation was diagnosed with 82% of the patients. There was no statistically significant difference between anticoagulant and other treatment in death or disability at final follow-up (at least 3 months) (73.5% vs 73.8%; OR 1.01, 95% CI 0.82 to 1.24) or all strokes (OR 1.18, 95% CI 0.74 to 1.88). Anticoagulants were associated with a non significant reduction in recurrent stroke within 7 to 14 days compared with other treatments (3.0% vs 4.9%; OR 0.68, 95% CI 0.44 to 1.06, NNT=53), but were associated with a significant increase in symptomatic intracranial bleeding (2.5% vs 0.7%; OR 2.89, 95% CI 1.19 to 7.01, NNH =55).