New oral anticoagulants and related anxiety symptoms

Newer oral anticoagulants (NOACs), now most commonly referred to as direct oral anticoagulants (DOACs), have replaced warfarin in preventing clot formation and minimizing the risk of stroke in patients with atrial fibrillation. Unlike warfarin, which exerts its anticoagulant effect indirectly by inhibiting vitamin K metabolism, DOACs have a direct anticoagulant effect via inhibition of specific coagulation factors such as activated factor II (Iia, thrombin) or activated factor X (Xa). Not only are DOACs highly effective and convenient for patients, they also do not entail the close monitoring of pharmacologic effect required with warfarin. As a result, their use is included in clinical guidelines and favored by clinicians as first‐line treatment.