Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation
Authors: Ishak A. Mansi, Sujata Bhushan, David E. Albracht
Journal: Annals of Internal Medicine (2021)

LettersOctober 2021Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial FibrillationIshak A. Mansi, MD, Sujata Bhushan, MD, David E. Albracht, MDIshak A. Mansi, MDVA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TexasSearch for more papers by this author, Sujata Bhushan, MDVA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TexasSearch for more papers by this author, David E. Albracht, MDVA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TexasSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L21-0563 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Dawwas and colleagues' article (1) adds valuable information on the use of DOACs (1). However, the message of the title, abstract, and introduction seems to differ from the results of their study.The American College of Cardiology Clinical Expert Consensus Document Task Force defined nonvalvular AF as AF in the absence of rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair (2). The American College of Chest Physicians guidelines considered VHD and AF to include mitral stenosis and prosthetic heart valves (3). Clinical trials of DOACs, which intended to avoid enrolling patients with ...References1. Dawwas GK, Dietrich E, Cuker A, et al. Effectiveness and safety of direct oral anticoagulants versus warfarin in patients with valvular atrial fibrillation. A population-based cohort study. Ann Intern Med. 2021;174:910-9. [PMID: 33780291] doi:10.7326/M20-6194 LinkGoogle Scholar2. Doherty JU, Gluckman TJ, Hucker WJ, et al. 2017 ACC expert consensus decision pathway for periprocedural management of anticoagulation in patients with nonvalvular atrial fibrillation. A report of the American College of Cardiology Clinical Expert Consensus Document Task Force. J Am Coll Cardiol. 2017;69:871-98. [PMID: 28081965] doi:10.1016/j.jacc.2016.11.024 CrossrefMedlineGoogle Scholar3. Singer DE, Albers GW, Dalen JE, et al. Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:546S-92S. [PMID: 18574273] doi:10.1378/chest.08-0678 CrossrefMedlineGoogle Scholar4. Fauchier L, Philippart R, Clementy N, et al. How to define valvular atrial fibrillation. Arch Cardiovasc Dis. 2015;108:530-9. [PMID: 26184867] doi:10.1016/j.acvd.2015.06.002 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TexasDisclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L21-0563. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation Ghadeer K. Dawwas , Eric Dietrich , Adam Cuker , Geoffrey D. Barnes , Charles E. Leonard , and James D. Lewis Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation Benjamin A. Rodwin Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation Ghadeer K. Dawwas , Geoffrey D. Barnes , Adam Cuker , and James D. Lewis Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation Siddharth Shah and Jalaj Garg Metrics October 2021Volume 174, Issue 10Page: 1489 ePublished: 19 October 2021 Issue Published: October 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...