Response to “Characteristics of the prothrombotic milieu in mitral stenosis patients managed with direct oral anticoagulants”

We read Dr. Jolobe's valuable comments regarding our study. We believe that any recommendation on the utility of direct oral anticoagulants (DOACs) in mitral stenosis (MS) patients with atrial fibrillation (AF) should only be based on the recently published INVICTUS trial [1] providing reliable evidence on the superiority of vitamin K antagonists (VKAs) compared to DOACs. However, the excellent time-in-therapeutic-range in the VKA group in INVICTUS [1] is in contrast with the current real-world experience in countries with a high prevalence of rheumatic heart disease [2], which opens a debate on the transferability of INVICTUS results to the “real world”.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research