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Patients with Atrial Fibrillation receiving NOACs: The boundary between appropriate and inappropriate dose

      Since their introduction in 2010, non-vitamin K oral anticoagulants (NOACs) changed the landscape of stroke prevention in patients with atrial fibrillation (AF). Because of their favorable benefit-harm profile, the fixed dose administration, the no need for laboratory monitoring and dose adjustment, NOAC prescription increased rapidly and overcome the use of vitamin K antagonists (VKAs) [
      • Zhu J
      • Alexander GC
      • Nazarian S
      • Segal JB
      • Wu AW.
      Trends and Variation in Oral Anticoagulant Choice in Patients with Atrial Fibrillation, 2010-2017.
      ,
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      • et al.
      ESC scientific document group. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European association for cardio-thoracic surgery (EACTS).
      ].
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      Linked Article

      • Effectiveness and safety of high and low dose NOACs in patients with atrial fibrillation
        European Journal of Internal MedicineVol. 88
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          Non-vitamin K antagonist oral anticoagulants (NOACs) were marketed in 2011 as alternatives to Vitamin K Antagonists (VKA) for treatment of thromboembolic risk in atrial fibrillation (AF) patients. Pivotal studies demonstrated the non-inferior effectiveness and the superior safety of NOACs compared to VKAs. International guidelines currently recommend NOACs over VKAs for thromboprophylaxis of AF [1], leading to a progressive uptake of NOACs [2]. One of the crucial aspect in the management of NOACs, is the appropriate choice of the drug dose [1].
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