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Patients with valvular heart disease other than mechanical prosthetic valves or severe mitral stenosis (including those with bioprosthetic valves) were included in pivotal trials demonstrating the benefit of NOACs over VKAs, and consensus guidelines recommend NOACs over VKAs in these patients. Subsequent devoted randomized controlled trials in patients with AF and bioprosthetic valves, including transcatheter valves, have confirmed the safety of NOACs in this population. In patients with rheumatic mitral stenosis, observational studies indicate that NOACs may be safe and effective, but randomized controlled trials are ongoing. By contrast, a randomized controlled trial showed that dabigatran is harmful in patients with mechanical prosthetic mitral valves; however, these data may not extrapolate to patients with mechanical valve prostheses in other locations or to other NOACs, and randomized controlled trials are ongoing. In this review, we discuss these data in greater depth, and make recommendations for the use of NOACs in patients with valvular heart disease.<\/jats:p>","DOI":"10.1093\/eurheartj\/suab151","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T06:03:46Z","timestamp":1645077826000},"page":"A19-A31","source":"Crossref","is-referenced-by-count":19,"title":["Non-vitamin K antagonist oral anticoagulants in patients with valvular heart disease"],"prefix":"10.1093","volume":"24","author":[{"given":"Alexander C","family":"Fanaroff","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine; Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center; and Leonard Davis Institute for Health Economics, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit N","family":"Vora","sequence":"additional","affiliation":[{"name":"UPMC Heart and Vascular Institute, Harrisburg, PA, USA"},{"name":"Division of Cardiovascular Medicine, Department of Medicine, Duke University, 2400 Pratt St, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato D","family":"Lopes","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Duke University, 2400 Pratt St, Durham, NC 27710, USA"},{"name":"Duke Clinical Research Institute, Duke University, PO Box 17969, Durham, NC 27715, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,14]]},"reference":[{"key":"2022021706033729200_suab151-B1","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1056\/NEJMoa0905561","article-title":"Dabigatran versus warfarin in patients with atrial 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