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The potential effect of direct oral anticoagulants (DOACs) treatment on miR-27a-3p expression and their broader regulative effect on anticoagulation is unknown. Fifty-nine atrial fibrillation patients treated with rivaroxaban (<jats:italic>n<\/jats:italic>\u2009=\u200919), apixaban (<jats:italic>n<\/jats:italic>\u2009=\u200927) or dabigatran (<jats:italic>n<\/jats:italic>\u2009=\u200913), were included in the study. miR-27a-3p expression was analyzed at baseline and after 7 days of DOAC therapy by using a predesigned TaqMan assay. Relative quantitation of miR-27a-3p expression was calculated and compared in pooled population and in different sample groups. DOAC therapy did not alter miR-27a-3p expression (0.80 fold-change, <jats:italic>p<\/jats:italic>\u2009=\u20090.486, pooled population; 0.839 fold-change, <jats:italic>p<\/jats:italic>\u2009=\u20090.706, rivaroxaban; 0.921 fold-change, <jats:italic>p<\/jats:italic>\u2009=\u20090.800, apixaban; 0.733 fold-change, <jats:italic>p<\/jats:italic>\u2009=\u20090.540, dabigatran). miR-27a-3p expression did not differ between controls and bleeding cases (0.833 fold-change, <jats:italic>p<\/jats:italic>\u2009=\u20090.588, baseline). Female patients had a trend towards increased baseline expression (1.564 fold-change, <jats:italic>p<\/jats:italic>\u2009=\u20090.177) and reduced expression after DOAC treatment (0.683 fold-change, <jats:italic>p<\/jats:italic>\u2009=\u20090.243) compared to male patients. Despite the regulatory role of miR-27a-3p on coagulation cascade, treatment with DOACs did not alter its expression. However, additional studies in different ethnic groups are necessary to fully elucidate the effect, if any, of DOACs on miR-27a-3p expression.<\/jats:p>\n          <jats:p>\n            <jats:bold>Graphical Abstract<\/jats:bold>\n          <\/jats:p>","DOI":"10.1007\/s11239-025-03102-5","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T11:56:07Z","timestamp":1745236567000},"page":"636-645","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Direct oral anticoagulants do not affect miR-27a-3p expression, a regulator of coagulation cascade, in atrial fibrillation patients"],"prefix":"10.1007","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2421-5677","authenticated-orcid":false,"given":"Georgia","family":"Ragia","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0918-5773","authenticated-orcid":false,"given":"Myria","family":"Pallikarou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chrysoula","family":"Michou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Thomopoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4331-730X","authenticated-orcid":false,"given":"Georgios","family":"Chalikias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4367-805X","authenticated-orcid":false,"given":"Athanasios","family":"Trikas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4982-9181","authenticated-orcid":false,"given":"Dimitrios N.","family":"Tziakas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0849-5469","authenticated-orcid":false,"given":"Vangelis G.","family":"Manolopoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"key":"3102_CR1","doi-asserted-by":"publisher","first-page":"1244098","DOI":"10.3389\/fphar.2023.1244098","volume":"14","author":"N Atzemian","year":"2023","unstructured":"Atzemian N, Kareli D, Ragia G, Manolopoulos VG (2023) Distinct pleiotropic effects of direct oral anticoagulants on cultured endothelial cells: a comprehensive review. 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