Summary

Four conditions drive the clinical conundrum regarding the use of novel oral anticoagulants in patients also receiving dual antiplatelet therapy (DAPT): atrial fibrillation, left ventricular and intracardiac thrombus, mechanical valve prosthesis, and venous thrombotic disease and pulmonary embolism. Recurrent thrombotic events in patients on DAPT also could be considered a legitimate addition to this list. This article reviews the evidence for treatment approaches.