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NOAC – Cardiology MCQ – Answer

In which of the following conditions non-vitamin K antagonist oral anticoagulants (NOACs) should not be used:

Correct answer: c) Mechanical prosthetic valve with atrial fibrillation

Subgroup analysis of certain clinical trials support the use of rivaroxaban, apixaban, dabigatran and edoxaban in patients with aortic stenosis, aortic regurgitation or mitral regurgitation patients having atrial fibrillation. NOACs can also be used in aortic bioprosthesis with atrial fibrillation if the valve was implanted more than 3 months back.

NOACs are better avoided in those with moderate or severe mitral stenosis and atrial fibrillation in view of high thromboembolic risk.

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  1. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Muñoz D, Rosenhek R, Sjögren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017 Sep 21;38(36):2739-2791.
MCQs in Medicine - Cardiovascular System is based on undergraduate medical curriculum. Though the questions are aimed at basic post graduate entrance examinations, candidates taking competitive exams at the post graduate exit level may also find them useful, especially the explanations for the answers. Undergraduate medical students will find them useful for answering MCQ tests in their regular exams. More than just answering MCQs, the explanations will improve the knowledge and understanding about the conditions discussed.Medicine MCQs - Cardiovascular System Kindle Edition: Click Here for a Preview Comments and suggestions are most welcome.