Clinical Knowledge Question Results

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Question: Per 2019 revised guidelines on atrial fibrillation from the American College of Cardiology, American Heart Association and the Heart Rhythm Society (ACC/AHA/HRS), which of the following patients in atrial fibrillation (AF) would NOT be a potential candidate for antithrombotic therapy with a direct acting oral anticoagulant (DOAC):

38% of
Medical Professionals
Chose A


8% of
Medical Professionals
Chose B


0% of
Medical Professionals
Chose C

54% of
Medical Professionals
Chose D

Answer: D. In a change from previous recommendations, recent guideline updates are de-emphasizing the concept of nonvalvular heart disease and now advise against use of DOACs specifically for patients with a mechanical heart valve or moderate to severe mitral stenosis, but have otherwise broadened the use of DOACs in patients with atrial fibrillation. In general, the risk of bleeding complications from DOACs are lower than with vitamin K antagonists.


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