Documento de toma de posición sobre el uso de anticoagulantes orales directos en fibrilación auricular no valvular;
Position Document on the Use of Direct Oral Anticoagulants in Nonvalvular Atrial Fibrillation

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ArgentineFederation of Cardiology have carried out a detailedanalysis of the recent Ninth Health TechnologyAssessment Report by the National Commission forHealth Technology Assessment (CONETEC) on theuse of direct oral anticoagulants in nonvalvular atrialfibrillation. (1)Atrial fibrillation (AF) represents 60% of the indicationsfor anticoagulation in Argentina and worldwide.The view of AF reality in our country shouldtake into account that AF is not systematically detected,anticoagulation is rarely performed, and when itis, the levels of time in therapeutic range (TTR) areinadequate, as we have verified in our records.We believe that this assessment has its limitations:it was carried out under economistic rather thanhealthcare criteria, which means that the conclusionsdrawn are not oriented towards the correct use of avaluable resource such as the new non-vitamin K-dependentdirect oral anticoagulants (DOACs) and theirpositive impact on AF patients, but rather to theirrestrictive use due to their high cost, without counterbalancingaspects as the correct training of physiciansin concepts such as the rational prescription ofDOACs.