ArticleEuropean heart journal supplements : journal of the European Society of Cardiology2022
Non-vitamin K antagonist oral anticoagulants in patients with valvular heart disease.
Article in European heart journal supplements : journal of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Clinical Assessment of Thromboembolic Risk in Patients Undergoing Elective Electrical Cardioversion with or Without Transesophageal Echocardiography: A Real-World Observational Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Modulatory Effects of Dabigatran on PAR-1 Activity and Viability in Adipose-Derived Mesenchymal Stem Cells.International journal of molecular sciences · 2026Article
- Brazilian Atrial Fibrillation Guidelines - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Non-Vitamin K Antagonist Oral Anticoagulants for Thromboembolic Prevention in Patients with Atrial Fibrillation and Concomitant Mitral Stenosis: A Retrospective Observational Study.Acta Cardiologica Sinica · 2025Article
- Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology - 2024.Arquivos brasileiros de cardiologia · 2024Article
- Optimizing Anticoagulation in Valvular Heart Disease: Navigating NOACs and VKAs.Journal of personalized medicine · 2024Review
- Comparison between non-vitamin K oral antagonist versus warfarin in atrial fibrillation with and without valvular heart disease: a systematic review and meta-analysis.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2024Review
- Update of Anticoagulation Use in Cardioembolic Stroke With a Special Reference to Endovascular Treatment.Journal of stroke · 2024Review
- Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Review
- Article
- Management of atrial fibrillation in rheumatic heart disease.Heart rhythm O2 · 2022Review
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The non-vitamin K antagonist oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban, and edoxaban have transformed the management of atrial fibrillation (AF), but are only approved by regulatory authorities for stroke prophylaxis in patients with so-called "non-valvular AF." This terminology has spawned confusion about which patients with valvular heart disease benefit from NOACs and which should be treated with vitamin K antagonists (VKAs) instead. Patients with valvular heart disease other than mechanical prosthetic valves or severe mitral stenosis (including those with bioprosthetic valves) were included in pivotal trials demonstrating the benefit of NOACs over VKAs, and consensus guidelines recommend NOACs over VKAs in these patients. Subsequent devoted randomized controlled trials in patients with AF and bioprosthetic valves, including transcatheter valves, have confirmed the safety of NOACs in this population. In patients with rheumatic mitral stenosis, observational studies indicate that NOACs may be safe and effective, but randomized controlled trials are ongoing. By contrast, a randomized controlled trial showed that dabigatran is harmful in patients with mechanical prosthetic mitral valves; however, these data may not extrapolate to patients with mechanical valve prostheses in other locations or to other NOACs, and randomized controlled trials are ongoing. In this review, we discuss these data in greater depth, and make recommendations for the use of NOACs in patients with valvular heart disease.
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