NEW STRATEGIES IN ANTICOAGULATION MANAGEMENT OF ATRIAL FIBRILLATION: A COMPARISON BETWEEN NOACS AND TRADITIONAL ANTICOAGULANTS

Abstract

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in clinical practice and is significantly associated with an increased risk of ischemic stroke and thromboembolic complications. Warfarin, the classic oral anticoagulant, has been widely used for decades; however, its limitations, such as the need for frequent INR monitoring and numerous drug and food interactions, compromise its effectiveness and patient adherence. Direct oral anticoagulants (DOACs) have emerged as a modern, effective, and safer alternative, with advantages demonstrated in recent clinical studies. This review aims to analyze contemporary anticoagulation strategies in AF, focusing on the comparison between DOACs and warfarin in terms of efficacy, safety, treatment adherence, and cost-effectiveness. Current evidence suggests that DOACs have a superior clinical profile, particularly in reducing intracranial bleeding and offering greater therapeutic convenience. Nonetheless, challenges related to individualized treatment and access, especially in public health systems, still hinder their widespread implementation. Rational incorporation of DOACs may represent a significant advance in the prevention of complications and in improving the quality of life for patients with AF.