Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation 2015

Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have emerged as an alternative to VKAs for thrombo-embolic prevention in patients with non-valvular atrial fibrillation (AF). Some authors refer to these drugs as ‘direct oral anticoagulants’ (DOACs), but since the term NOAC has been used for many years and is widely recognized, we prefer to continue to use NOAC. Nonvitamin K antagonist oral anticoagulants have an improved efficacy/safety ratio, predictable effect without need for routine monitoring, and fewer food and drug interactions compared with VKAs. However, the proper use of NOACs requires different approaches to many practical aspects compared with VKAs. Whereas the ESC Guidelines mainly discuss the indications for anticoagulation in general (e.g. based on the CHA2DS2-VASc score) and of NOACs

in particular, they offer less guidance on how to deal with NOACs in specific clinical situations.