The pivotal aim of oral anticoagulation in atrial fibrillation (AF) is prevention of AF-related thromboembolic strokes. The vitamin K antagonists (eg, warfarin) have been the standard of care for many years, reducing both stroke and mortality rates by 64% and 26% respectively, compared with placebo/control.1 Approval and market release of direct oral anticoagulants (DOACs; also referred to as non-vitamin K antagonist oral anticoagulants2), such as dabigatran, rivaroxaban, apixaban, and edoxaban, have changed the landscape of thromboprophylaxis substantially.