{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:06:31Z","timestamp":1790643991520,"version":"4.1.0"},"reference-count":71,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Atrial fibrillation (AF) is a common cardiac arrhythmia that poses a significant risk of stroke and thromboembolic events. Anticoagulation therapy is essential for preventing stroke in patients with AF. An increasing number of people of all ages, including cardiac patients, approach physical activity as both a leisure-time exercise and a competitive sport. Therefore, patients at risk of AF are increasingly allowed to practice sports activities. Management of oral anticoagulant therapy (OAT) in these patients is extremely challenging because of the need to balance the risks and benefits of medications, considering both hemorrhagic (in case of trauma) and ischemic complications when the drugs are avoided. Official recommendations are limited for these patients and forbid sports that increase the risk of trauma and consequent bleeding in most cases. These recommendations are strongly influenced by the \u201ctraditional\u201d management of OAT, which mainly involves coumarin derivatives. Non-vitamin K antagonist direct oral anticoagulants (DOACs), with their more favorable pharmacokinetic\u2013pharmacodynamic profile than that of coumarin derivatives, may represent an opportunity to modify the approach to sports activity in patients with AF and indications for OAT. This study aimed to review the use of anticoagulants in athletes with AF, highlight their efficacy and safety, and provide practical considerations regarding their management.<\/jats:p>","DOI":"10.3389\/fphar.2024.1384213","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T05:02:41Z","timestamp":1715317361000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Thromboembolic prevention in athletes: management of anticoagulation in sports players affected by atrial fibrillation"],"prefix":"10.3389","volume":"15","author":[{"given":"Simona","family":"Minardi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Sciarra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Gianluca","family":"Robles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Scara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Sciarra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"De Masi De Luca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Romano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.1093\/europace\/eup197","article-title":"Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis","volume":"11","author":"Abdulla","year":"2009","journal-title":"Europace"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1016\/j.amjcard.2009.01.374","article-title":"Relation of vigorous exercise to risk of atrial fibrillation","volume":"103","author":"Aizer","year":"2009","journal-title":"Am. J. Cardiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"3624","DOI":"10.1093\/eurheartj\/eht188","article-title":"Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study","volume":"34","author":"Andersen","year":"2013","journal-title":"Eur. Heart J."},{"key":"B4","article-title":"Cardiological organizational committee for suItability for competitive sport - FMSI \u2013 SIC SPORT -ance \u2013 ANMCO \u2013 SIC","volume-title":"Cardiological protocols for the assessment of suitability for competitive sport (COCIS)","year":"2023"},{"key":"B5","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.ijcha.2018.01.002","article-title":"Age modifies the risk of atrial fibrillation among athletes: a systematic literature review and meta-analysis","volume":"18","author":"Ayinde","year":"2018","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1111\/jth.13676","article-title":"Athletes and blood clots: individualized, intermittent anticoagulation management","volume":"15","author":"Berkowitz","year":"2017","journal-title":"J. Thrombosis Haemostasis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"101483","DOI":"10.1016\/j.cpcardiol.2022.101483","article-title":"Present knowledge on direct oral anticoagulant and novel oral anti coagulants and their specific antidotes: a comprehensive review article","volume":"48","author":"Biswas","year":"2023","journal-title":"Curr. Probl. Cardiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1159\/000447214","article-title":"Perioperative management of new oral anticoagulants in urological surgery","volume":"11","author":"Browne","year":"2018","journal-title":"Curr. Urol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1097\/00001721-199306000-00011","article-title":"Factor VIII and DDAVP reverse the effect of recombinant desulphatohirudin (CGP 39393) on bleeding in the rat","volume":"4","author":"Butler","year":"1993","journal-title":"Blood Coagul. fibrinolysis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1093\/europace\/euv216","article-title":"Emerging risk factors and the dose-response relationship between physical activity and lone atrial fibrillation: a prospective case-control study","volume":"18","author":"Calvo","year":"2016","journal-title":"Europace"},{"key":"B11","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1111\/jth.12823","article-title":"Real-world variability in dabigatran levels in patients with atrial fibrillation","volume":"13","author":"Chan","year":"2015","journal-title":"J. Thromb. Haemost."},{"key":"B12","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1177\/03635465211060340","article-title":"Epidemiology of concussions in national collegiate athletic association (NCAA) sports","volume":"50","author":"Chandran","year":"2022","journal-title":"Am. J. Sports Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1016\/j.jacc.2014.11.046","article-title":"Should atrial fibrillation patients with 1 additional risk factor of the CHA2DS2-VASc score (beyond sex) receive oral anticoagulation?","volume":"65","author":"Chao","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1016\/s0149-2918(01)80109-0","article-title":"A systematic review of the associations between dose regimens and medication compliance","volume":"23","author":"Claxton","year":"2001","journal-title":"Clin. Ther."},{"key":"B15","doi-asserted-by":"publisher","first-page":"874","DOI":"10.2459\/JCM.0000000000001186","article-title":"Italian cardiological guidelines (COCIS) for competitive sport eligibility in athletes with heart disease: update 2020","volume":"22","author":"Delise","year":"2021","journal-title":"J. Cardiovasc Med. Hagerst."},{"key":"B16","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.gie.2013.04.179","article-title":"Novel oral anticoagulants in gastroenterology practice","volume":"78","author":"Desai","year":"2013","journal-title":"Gastrointest. Endosc."},{"key":"B17","doi-asserted-by":"publisher","first-page":"e207","DOI":"10.1016\/j.chest.2022.07.025","article-title":"Perioperative management of antithrombotic therapy: an American College of chest physicians clinical practice guideline","volume":"162","author":"Douketis","year":"2022","journal-title":"CHEST"},{"key":"B18","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1111\/jth.13912","article-title":"Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians","volume":"16","author":"Douxfils","year":"2018","journal-title":"J. Thromb. Haemost."},{"key":"B19","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1016\/j.thromres.2012.09.004","article-title":"Assessment of the impact of rivaroxaban on coagulation assays: laboratory recommendations for the monitoring of rivaroxaban and review of the literature","volume":"130","author":"Douxfils","year":"","journal-title":"Thromb. Res."},{"key":"B20","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1160\/TH11-11-0804","article-title":"Impact of dabigatran on a large panel of routine or specific coagulation assays. Laboratory recommendations for monitoring of dabigatran etexilate","volume":"107","author":"Douxfils","year":"","journal-title":"Thromb. Haemost."},{"key":"B21","doi-asserted-by":"publisher","first-page":"3S","DOI":"10.1714\/2076.22504","article-title":"Nuovi anticoagulanti orali: considerazioni di farmacologia clinica","volume":"16","author":"Ferri","year":"2015","journal-title":"G. Ital. Cardiol. (Rome)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1016\/j.hlc.2017.05.132","article-title":"State of the art review: atrial fibrillation in athletes","volume":"26","author":"Flannery","year":"2017","journal-title":"Heart, Lung Circulation"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2370","DOI":"10.1001\/jama.285.18.2370","article-title":"Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study","volume":"285","author":"Go","year":"2001","journal-title":"JAMA"},{"key":"B24","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1097\/HJR.0b013e32833226be","article-title":"High prevalence of atrial fibrillation in long-term endurance cross-country skiers: echocardiographic findings and possible predictors-a 28\u201330 years follow-up study","volume":"17","author":"Grimsmo","year":"2010","journal-title":"Eur. J. Cardiovasc Prev. Rehabil."},{"key":"B25","doi-asserted-by":"publisher","first-page":"3826","DOI":"10.1093\/eurheartj\/ehac270","article-title":"2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery","volume":"43","author":"Halvorsen","year":"2022","journal-title":"Eur. Heart J."},{"key":"B26","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1055\/s-0038-1668098","article-title":"Detecting anti-IIa and anti-Xa direct oral anticoagulant (DOAC) agents in urine using a DOAC dipstick","volume":"45","author":"Harenberg","year":"2019","journal-title":"Semin. Thromb. Hemost."},{"key":"B27","doi-asserted-by":"publisher","first-page":"857","DOI":"10.7326\/0003-4819-146-12-200706190-00007","article-title":"Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation","volume":"146","author":"Hart","year":"2007","journal-title":"Ann. Intern Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s42466-021-00105-4","article-title":"Point-of-care testing for emergency assessment of coagulation in patients treated with direct oral anticoagulants including edoxaban","volume":"3","author":"Hartig","year":"2021","journal-title":"Neurol. Res. Pract."},{"key":"B29","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1097\/01.hjr.0000216543.54066.72","article-title":"Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions Part I: supraventricular arrhythmias and pacemakers","volume":"13","author":"Heidb\u00fcchel","year":"2006","journal-title":"Eur. J. Cardiovasc Prev. Rehabil."},{"key":"B30","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1097\/01.hjr.0000239465.26132.29","article-title":"Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions Part II: ventricular arrhythmias, channelopathies and implantable defibrillators","volume":"13","author":"Hein","year":"2006","journal-title":"Eur. J. Cardiovasc. Prev. Rehabilitation"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS)","volume":"2020","author":"Hindricks","year":"2020","journal-title":"Eur. Heart J."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e125","DOI":"10.1161\/CIR.0000000000000665","article-title":"2019 AHA\/ACC\/HRS focused update of the 2014 AHA\/ACC\/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of cardiology\/American heart association task force on clinical practice guidelines and the heart rhythm society in collaboration with the society of thoracic surgeons","volume":"140","author":"January","year":"2019","journal-title":"Circulation"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1784","DOI":"10.1136\/bmj.316.7147.1784","article-title":"Lone atrial fibrillation in vigorously exercising middle aged men: case-control study","volume":"316","author":"Karjalainen","year":"1998","journal-title":"BMJ"},{"key":"B34","doi-asserted-by":"publisher","first-page":"2893","DOI":"10.1093\/eurheartj\/ehw210","article-title":"2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS","volume":"37","author":"Kirchhof","year":"2016","journal-title":"Eur. Heart J."},{"key":"B35","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1016\/j.ahj.2013.05.015","article-title":"Improving outcomes in patients with atrial fibrillation: rationale and design of the Early treatment of Atrial fibrillation for Stroke prevention Trial","volume":"166","author":"Kirchhof","year":"2013","journal-title":"Am. Heart J."},{"key":"B36","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/eht265","article-title":"Atrial fibrillation in athletes and the interplay between exercise and health","volume":"34","author":"La Gerche","year":"2013","journal-title":"Eur. Heart J."},{"key":"B37","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/S0140-6736(12)61031-9","article-title":"Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy","volume":"380","author":"Lee","year":"2012","journal-title":"Lancet"},{"key":"B38","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1111\/jth.13894","article-title":"Rivaroxaban reversal with prothrombin complex concentrate or tranexamic acid in healthy volunteers","volume":"16","author":"Levy","year":"2018","journal-title":"J. Thromb. Haemost."},{"key":"B39","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1378\/chest.09-1584","article-title":"Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation","volume":"137","author":"Lip","year":"2010","journal-title":"Chest"},{"key":"B40","doi-asserted-by":"publisher","first-page":"2343","DOI":"10.1016\/j.jacc.2015.09.032","article-title":"Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: preamble, principles, and general considerations: a scientific statement from the American heart association and American College of cardiology","volume":"66","author":"Maron","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1177\/2047487312460484","article-title":"Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European association for cardiovascular prevention and rehabilitation, the American association of cardiovascular and pulmonary rehabilitation and the Canadian association of cardiac rehabilitation","volume":"20","author":"Mezzani","year":"2013","journal-title":"Eur. J. Prev. Cardiol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1182\/asheducation-2018.1.412","article-title":"Elite athletes and anticoagulant therapy: an intermittent dosing strategy","volume":"2018","author":"Moll","year":"2018","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program."},{"key":"B43","doi-asserted-by":"publisher","first-page":"2307","DOI":"10.1093\/eurheartj\/ehw059","article-title":"Physical activity, resting heart rate, and atrial fibrillation: the Tromso Study","volume":"37","author":"Morseth","year":"2016","journal-title":"Eur. Heart J."},{"key":"B44","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1161\/CIRCULATIONAHA.108.785626","article-title":"Physical activity and incidence of atrial fibrillation in older adults: the cardiovascular health study","volume":"118","author":"Mozaffarian","year":"2008","journal-title":"Circulation"},{"key":"B45","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1007\/s00392-015-0898-0","article-title":"Physical activity, symptoms, medication and subjective health among veteran endurance athletes with atrial fibrillation","volume":"105","author":"Myrstad","year":"2016","journal-title":"Clin. Res. Cardiol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1136\/bjsports-2021-103994","article-title":"Risk of atrial fibrillation in athletes: a systematic review and meta-analysis","volume":"55","author":"Newman","year":"2021","journal-title":"Br. J. Sports Med."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1115328","DOI":"10.3389\/fcvm.2023.1115328","article-title":"Long-term follow-up in paroxysmal atrial fibrillation patients with documented isolated trigger","volume":"10","author":"Palam\u00e0","year":"2023","journal-title":"Front. Cardiovasc. Med."},{"key":"B48","first-page":"897","article-title":"Real world discontinuation among early users of apixaban, dabigatran, rivaroxaban or warfarin among atrial fibrillation patients newly initiated on anticoagulation therapy: tell of first 200 days","volume":"35","author":"Pan","year":"2014","journal-title":"Eur. Heart J."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1422","DOI":"10.1093\/eurheartj\/ehi325","article-title":"Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the study group of sports cardiology of the working group of cardiac rehabilitation and exercise physiology and the working group of myocardial and pericardial diseases of the European society of cardiology","volume":"26","author":"Pelliccia","year":"","journal-title":"Eue Heart J."},{"key":"B50","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1016\/j.jacc.2005.04.052","article-title":"Prevalence and clinical significance of left atrial remodeling in competitive athletes","volume":"46","author":"Pelliccia","year":"","journal-title":"J. Am. Coll. Cardiol."},{"key":"B51","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/eurheartj\/ehaa735","article-title":"The \u2018ten commandments\u2019 for the 2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease","author":"Pelliccia","year":"2020","journal-title":"Eur. Heart J."},{"key":"B52","doi-asserted-by":"publisher","first-page":"218","DOI":"10.3390\/jcdd10050218","article-title":"Long-term sports practice and atrial fibrillation: an updated review of a complex relationship","volume":"10","author":"Petrungaro","year":"2023","journal-title":"J. Cardiovasc. Dev. Dis."},{"key":"B53","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.1111\/j.1538-7836.2012.04859.x","article-title":"Reversal of dabigatran anticoagulation by prothrombin complex concentrate (Beriplex P\/N) in a rabbit model","volume":"10","author":"Pragst","year":"2012","journal-title":"J. Thromb. Haemos"},{"key":"B54","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1542\/peds.2008-0080","article-title":"Medical conditions affecting sports participation","volume":"121","author":"Rice","year":"2008","journal-title":"Pediatrics"},{"key":"B55","doi-asserted-by":"publisher","first-page":"98","DOI":"10.23736\/S0026-4725.20.05177-4","article-title":"Non vitamin K antagonist oral anticoagulants and sport","volume":"68","author":"Romano","year":"2020","journal-title":"Minerva Cardioangiol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.thromres.2019.10.006","article-title":"Residual anticoagulation activity in atrial fibrillation patients with temporary interrupted direct oral anticoagulants: comparisons across 4 drugs","volume":"183","author":"Sairaku","year":"2019","journal-title":"Thromb. Res."},{"key":"B57","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.chest.2016.08.1462","article-title":"Laboratory assessment of the anticoagulant activity of direct oral anticoagulants: a systematic review","volume":"151","author":"Samuelson","year":"2017","journal-title":"Chest"},{"key":"B58","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.ijcard.2016.10.047","article-title":"Atrial fibrillation in highly trained endurance athletes \u2014 description of a syndrome","volume":"226","author":"Sanchis-Gomar","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"B59","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.jjcc.2018.04.011","article-title":"Atrial fibrillation in athletes: from epidemiology to treatment in the novel oral anticoagulants era","volume":"72","author":"Sanna","year":"2018","journal-title":"J. Cardiol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"554","DOI":"10.23736\/S0022-4707.21.12831-2","article-title":"Managing athletes with palpitations of unknown origin with an external loop recorder: a cohort study","volume":"62","author":"Sciarra","year":"2022","journal-title":"J. Sports Med. Phys. Fit."},{"key":"B61","volume-title":"Reloaded: searching for the perfect dose of exercise?","author":"Sharma","year":"2018"},{"key":"B62","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1182\/asheducation-2016.1.612","article-title":"Reversal of direct oral anticoagulants: a practical approach","volume":"2016","author":"Shih","year":"2016","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program"},{"key":"B63","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/europace\/euab065","article-title":"European heart RhythmAssociation practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation","author":"Steffel","year":"2021","journal-title":"Europace"},{"key":"B64","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1093\/eurheartj\/ehy136","article-title":"The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation","volume":"39","author":"Steffel","year":"2018","journal-title":"Eur. Heart J."},{"key":"B65","article-title":"Antithrombotic therapy in athletes: a balancing act","author":"Stewart","year":"2023","journal-title":"Am. Coll. Cardiol."},{"key":"B66","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1111\/jth.14001","article-title":"Low drug levels and thrombotic complications in high-risk atrial fibrillation patients treated with direct oral anticoagulants","volume":"16","author":"Testa","year":"2018","journal-title":"J. Thromb. Haemost."},{"key":"B67","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.ijcard.2016.03.056","article-title":"Specific antidotes against direct oral anticoagulants: a comprehensive review of clinical trials data","volume":"214","author":"Tummala","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"B68","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.amjmed.2011.10.017","article-title":"Interpretation of point-of-care INR results in patients treated with dabigatran","volume":"125","author":"van Ryn","year":"2012","journal-title":"Am. J. Med."},{"key":"B69","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s40256-013-0061-0","article-title":"New oral anticoagulants in practice: pharmacological and practical considerations","volume":"14","author":"Wang","year":"2014","journal-title":"Am. J. Cardiovasc Drugs"},{"key":"B70","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s00392-014-0805-0","article-title":"Atrial fibrillation and long-term sports practice: epidemiology and mechanisms","volume":"104","author":"Wernhart","year":"2015","journal-title":"Clin. Res. Cardiol."},{"key":"B71","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1160\/TH03-09-0605","article-title":"Effect of recombinant factor VIIa on melagatraninduced inhibition of thrombin generation and platelet activation in healthy volunteers","volume":"91","author":"Wolzt","year":"2004","journal-title":"Thromb. Haemost."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1384213\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T09:39:27Z","timestamp":1715593167000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1384213\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,10]]},"references-count":71,"alternative-id":["10.3389\/fphar.2024.1384213"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2024.1384213","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,10]]},"article-number":"1384213"}}