The currently approved direct oral anti-coagulants have proven to be safe and efficacious in prevention of stroke in patients with AF. However, the choice of DOAC is influenced by several factors including specific patient characteristics (renal function etc.), preference of OD versus BID, physicians comfort with the drug and the cost of drug to the patient.
While there are no head-to-head clinical trials conducted to-date between the DOACs, several observational studies have been performed to understand physicians' and patients' perspective about these direct oral anticoagulants.