Arq. Bras. Cardiol. 2025; 122(2): e20240795

Oral Anticoagulation with VKAs: Quality Above All!

Letícia Braga Ferreira , André Assis Lopes do Carmo

DOI: 10.36660/abc.20240795i

This Short Editorial is referred by the Research article "Incidence and Predictors of Clinical Outcomes in Patients with Valvular and Nonvalvular Atrial Fibrillation Using Vitamin K Antagonists".

Since their first Food and Drug Administration approval in 2010, direct oral anticoagulants (DOACs) have grown in use worldwide and have become the most common initially prescribed oral anticoagulation drug for patients with newly diagnosed atrial fibrillation. However, the high costs still hinder their utilization, especially in low and middle-income countries. Furthermore, in certain conditions, especially mechanical heart valves and rheumatic mitral stenosis, vitamin K antagonists (VKAs) remain the only drugs with established safety and efficacy.^,

Data from more than 400.000 patients from the United States show that after 2019, nearly 48% of patients with atrial fibrillation were prescribed DOAC, and only 17,7% were using warfarin. Such precise data about warfarin and DOAC utilization in Brazil are lacking but it is estimated that a higher proportion of patients are using VKAs.

[…]