Esteve-Pastor MA, et al. - Researchers assessed the real-world impact of non-vitamin K antagonist oral anticoagulants (NOACs) in optimally anticoagulated atrial fibrillation (AF) patients with acenocoumarol, with a focus on the absolute benefit in clinical outcomes rates. The analysis included patients stable on acenocoumarol with time in therapeutic range of 100%, with 6.5 years of follow-up. Data revealed estimated reductions in all clinical outcomes with various NOACs in these patients. With apixaban, the best effectiveness and safety profile was demonstrated. Compared with phase-III clinical trials, the estimated effect with real world NOACs would probably be higher.