Fast Five Quiz: Direct Oral Anticoagulant Therapy for Atrial Fibrillation

Sandeep K. Goyal, MD


April 02, 2020

DOAC therapy is not recommended for patients with AF who have mitral stenosis.

The 2019 American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Rhythm Society (HRS) Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients with Atrial Fibrillation, the 2016 European Society of Cardiology (ESC) Guidelines for the Management of Atrial Fibrillation Developed in Collaboration With EACTS (European Association for Cardio-Thoracic Surgery), and the 2018 European Heart Rhythm Association (EHRA) Practical Guide to the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With AF recommend DOAC agents over the VKA warfarin in eligible patients, except for those who have moderate to severe mitral stenosis or a mechanical heart valve.

There is no recommendation against giving DOAC agents to patients with AF who have aortic stenosis, aortic regurgitation, or mitral regurgitation.

Learn more about recommendations for anticoagulation therapy in patients who have AF and valvular heart disease.


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