Direct Oral Anticoagulants: Navigating Through Clinical Challenges

Cardiovasc Drugs Ther. 2023 Aug 8. doi: 10.1007/s10557-023-07499-0. Online ahead of print.

Abstract

Purpose: Direct oral anticoagulants (DOACs) have been approved, for over a decade, by both European and American medicine agencies, for treatment and prevention of several cardiovascular conditions. Since then, an increasing amount of data has been added to the medical literature day by day, resulting in a dichotomy in selection of the appropriate agent, dosage, and duration of treatment for special populations with multiple comorbidities. Considering these issues, we have prepared a comprehensive review for the clinical practitioner, to optimize the DOAC utilization in clinical practice.

Methods: A thorough literature search and review was conducted, concerning mainly the last decade. Our review focused on the current guidelines and the most recently published studies in PubMed, Science Direct Scopus, and Google Scholar to date.

Conclusion: The purpose of this study is to provide guidance for healthcare professionals for making proper decisions when confronted with clinical challenges. Nevertheless, further research is required to establish DOAC superiority in complicated cases, where there is clinical uncertainty.

Keywords: Clinical Challenges; Comorbidities; DOACs; Indications.

Publication types

  • Review