What advantages do DOACs have over warfarin therapy?
DOACs have important advantages over warfarin therapy, including a more predictable pharmacokinetic profile with no monitoring required, fewer interactions with other drugs, and a rapid onset/offset of action. It has been demonstrated that DOACs are noninferior or superior to dose-adjusted warfarin therapy to prevent thromboembolism and bleeding in patients with nonvalvular AF. However, larger-scale multicenter observational data will be necessary to determine if DOACs can be used safely in patients with congenital heart disease.