Abstract
Preventing thromboembolic events, while minimizing bleeding risks, remains challenging
when managing patients with atrial fibrillation. Despite large and successful trial
programs, several clinical concerns remain which commonly relate to fears of over-
or underexposure to drugs and unfavorable outcomes. After a short summary of the main
phase III trial findings, this short review discusses the evidence and clinical relevance
of common clinical concerns (correct direct oral anticoagulant [DOAC] dosing; DOAC
in moderate-to-severe renal impairment; and the relevance of fasting, nasogastric
tube feeding, or high body mass index) on DOAC plasma levels. Finally, the need for
specific DOAC antidotes will be addressed.
Keywords
direct oral anticoagulants - atrial fibrillation - stroke
