Invited Review ArticleUpdate on Direct Oral Anticoagulants in Atrial Fibrillation Patients Undergoing Cardiac Interventional Procedures From Clinical Trials to Real-World EvidenceMelillo, Enrico MD*; Carbone, Andreina MD*; Rago, Anna MD*; Papa, Andrea A. MD*; D'. Onofrio, Antonio MD†; Nigro, Gerardo MD, PhD*; Golino, Paolo MD, PhD*; Russo, Vincenzo MD, PhD*Author Information *Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli,” Naples, Italy; and †Departmental Unit of Electrophysiology, Evaluation and Treatment of Arrhythmias, Monaldi Hospital, Naples, Italy. Reprints: Vincenzo Russo, MD, PhD, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli,” 80131 Naples, Italy (e-mail: firstname.lastname@example.org). The authors report no conflicts of interest. Received August 26, 2019 Accepted November 28, 2019 Journal of Cardiovascular Pharmacology: March 2020 - Volume 75 - Issue 3 - p 185-199 doi: 10.1097/FJC.0000000000000786 Buy Metrics Abstract Direct oral anticoagulants (DOACs) are considered a first-line therapy for long-term stroke prevention in patients with nonvalvular atrial fibrillation (AF) and high thromboembolic risk. The potential role of DOACs in cardiac interventional procedures is a pressing clinical question, considering the increasing number of procedures and the growing prevalence of patients in DOAC therapy. The aim of this review is to provide an update on available evidence about the clinical performance of DOACs in AF patients undergoing different interventional procedures (AF cardioversion and ablation, and percutaneous coronary and structural heart disease interventions) and to explore the possible role of DOACs as an alternative therapeutic strategy in cardiac interventional procedures among non-AF patients. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.