We recommend that when OAC is indicated, warfarin be used rather than a NOAC for patients with a mechanical prosthetic valve, rheumatic mitral stenosis or eGFR of 15-30 ml/min/1.73 m2 (Strong Recommendation, Moderate Quality Evidence).

Practical tip: Patients should generally receive the higher of the two doses of the NOACs evaluated in the RCTs unless there is a specific reason to use the lower dose (e.g. advanced age, renal failure, small body weight) Practical tip: Among patients aged ≥75 receiving dabigatran, the dose should be 110 mg bid, because of better balance between risks of stroke and major bleeding.