Key result
Direct oral anticoagulants (DOACs) are favored as first-line treatment over warfarin for stroke prevention in atrial fibrillation due to their direct effect and lack of monitoring requirements.
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DOACs have replaced warfarin as first-line treatment for stroke prevention in atrial fibrillation due to their direct mechanism, efficacy, and lack of monitoring requirements.
Newer oral anticoagulants (NOACs), now most commonly referred to as direct oral anticoagulants (DOACs), have replaced warfarin in preventing clot formation and minimizing the risk of stroke in patients with atrial fibrillation. Unlike warfarin, which exerts its anticoagulant effect indirectly by inhibiting vitamin K metabolism, DOACs have a direct anticoagulant effect via inhibition of specific coagulation factors such as activated factor II (Iia, thrombin) or activated factor X (Xa). Not only are DOACs highly effective and convenient for patients, they also do not entail the close monitoring of pharmacologic effect required with warfarin. As a result, their use is included in clinical guidelines and favored by clinicians as first‐line treatment.
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Y. W. Francis Lam (2026) conducted a review in atrial fibrillation. Direct oral anticoagulants (DOACs) vs. Warfarin was evaluated. Direct oral anticoagulants (DOACs) are favored as first-line treatment over warfarin for stroke prevention in atrial fibrillation due to their direct effect and lack of monitoring requirements.
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