Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Emergency Medicine


Dr. Tom Colletti


Purpose: The purpose of this article is to compare the newer oral anticoagulants know as Non-vitamin K oral anticoagulants (NOACs) and Direct oral anticoagulants DOACs to Warfarin for the treatment of the nonvalvular cause of Atrial Fibrillation in specific patient populations.

Method: A PubMed literature search was conducted. From the home page of PubMed, using the advanced search link, "direct oral anticoagulant," "non-vitamin K oral anticoagulant," "atrial fibrillation," and "stroke" was typed into the search fields. After the review, a second search was done with "non-vitamin K oral anticoagulant," "direct oral anticoagulant," "atrial fibrillation," "warfarin," and "stroke" as key terms.

Results: In total, 32 meta-analyses were reviewed. The most relevant and recent studies were included and categorized for relevance.

Conclusion: Atrial fibrillation (AF) is a well-known and significant risk factor for a stroke. 1

For many years, warfarin and other Vitamin K antagonists have been used extensively for stroke risk reduction. However, warfarin's disadvantage includes a narrow therapeutic range and a multitude of drug interactions.2 In the last decade, we have seen an increase in the availability of oral anticoagulation options that try to address warfarin's disadvantages. NOACs and DOACs have emerged to be a safe, effective, and convenient option. Given the ease of dosing, they are rapidly becoming a treatment of choice.3 With the emergence of anticoagulation options, medical providers must individualize therapy to meet the needs of their patients.


Available when accessing via a campus IP address or logged in with a University of Lynchburg email address.

Off-campus users can also use 'Off-campus Download' button above for access.