Yokoyama Y, Briasoulis A, Ueyama H, et al. - Researchers compared direct anticoagulants (DOAC) and vitamin K antagonist (VKA) in patients with bioprosthetic valves and atrial fibrillation, by analyzing updated evidence. They identified relevant randomized control trials (RCT) and observational studies from MEDLINE and EMBASE. This analysis involved 4 RCTs and 6 observational studies with overall 6,405 patients assigned to the DOAC group (n =2,142) and VKA (n =4,263). Findings indicated that a reduction in major bleeding risk might be afforded by DOAC without elevating the risk of stroke or systemic embolism or all-cause death, relative to VKA, in patients with bioprosthetic valves and atrial fibrillation.