Pall T. Onundarson: Frail Elderly Korean Atrial Fibrillation Patients Do Worse If Switched to DOACs in a Nationwide Observational Study
Pall T. Onundarson, Professor Emeritus at Landspitali University Hospital, shared a post on LinkedIn:
“Frail elderly Korean atrial fibrillation patients do worse if switched to DOACs in a nationwide observational study.
This would appear to support the previous RCT of Joosten et al (Circulation. 2024;149:279–289. DOI: 10.1161/CIRCULATIONAHA.123.066485) from Holland.
It should also caution physicians against celebrating convenience over efficacy and safety if they are able to provide quality treatment with warfarin/VKAs.
It would also suggest that warfarin isn´t dead yet as treatment of NVAF – and that working on improved warfarin monitoring and outcomes remains worthwhile, even mandatory, for the benefit of patients.
There is an interesting read in a commentary from Karakasis (Eur Heart J 2026.) – and a rebuttal to that commentary from Lee and Choi (European Heart Journal (2026) 00, 1–2).”

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