MidregiOnal Proatrial Natriuretic Peptide to Guide SEcondary Stroke Prevention

Inclusion Criteria: * Clinical diagnosis of ischemic stroke * level ≥200pmol/L within 72 hours from symptom onset * Age ≥ 18 years * Signed informed consent Exclusion Criteria: * History of AF, AF on 12-lead ECG on admission or any AF ≥30 seconds during heart-rhythm monitoring prior to randomization * Other condition that require anticoagulant therapy (e.g., venous thromboembolism) as per Investigator's judgment including therapeutical dose of low-molecular-weight heparin or heparin * Strong likelihood to be treated with prolonged (i.e. more than 30 days) dual antiplatelet therapy during the course of the trial (such as coronary stenting, etc.) * Patients undergoing planned procedures where therapy with a DOAC is a contraindication (e.g. surgery) * Previous intracranial hemorrhage in the last year * Evidence of severe cerebral amyloid angiopathy if MRI scan performed * Chronic kidney disease with creatinin clearance \<30ml/min and or subject who requires haemodialysis or peritoneal dialysis * Known bleeding diathesis (e.g. active peptic ulcer disease , platelet count \< 100'000/mm3 or haemoglobin \< 9 g/dl or INR ≥ 1.7, documented haemorrhagic tendencies or blood dyscrasias) * Active infective endocarditis * CT or MRI evidence of cerebral vasculitis * Known allergy or intolerance to antiplatelets or DOACs * Female who is pregnant or lactating or has a positive pregnancy test at time of admission * Current participation in another drug trial