Clinician reference tool — not medical advice. This is a clinical decision-aid intended for healthcare professionals: it gives deterministic suggestions to think with, not a diagnosis or a prescription. If you’re a patient, you’re welcome to look around — but please review anything here with your own doctor; it isn’t a substitute for personalized medical care.
Reference tool — not medical advice. Deterministic, indication-gated, guideline-dated suggestions to think with; clinician judgement, dosing/renal adjustment, INR targets, duration, interactions, and live ODB coverage always required. Runs entirely in your browser — no data is collected.

Evidence: Giugliano RP 2093 · sources last checked 2026-08-20

Guideline updates
First published2026-07-02CCS/CHRS 2020ESC 2024ACC/AHA 2023CHEST 2021ASH 2021ACC/AHA 2020ESC/EACTS 2025AHA 2022ISTH 2020EULAR 2019Thrombosis Canada 2025

Built on the guideline editions listed above and published after physician review. Source list is machine-derived; independent verification is queued.

Reviewed and approved by the clinic physician · 2026-07-02.

This history lists guideline editions this tool follows and how updates changed its suggestions. It is not medical advice — always discuss decisions with your clinician.

Anticoagulant selector

Pick the clinical indication, choose the guideline lens, and enter the patient’s risk factors — get ranked, reasoned anticoagulant suggestions (DOACs, warfarin, LMWH) with the guideline/trial evidence and its year behind each.

1 · Clinical indication (required)

Select a clinical indication to begin.

Each indication asks for the risk factors its guidelines actually use — e.g. Atrial fibrillation builds a live CHA₂DS₂-VASc / CHADS-65 assessment.

References

  1. [1]Andrade JG, et al. 2020 CCS/CHRS Comprehensive Guidelines for the Management of Atrial Fibrillation (CHADS-65 pathway). Can J Cardiol 2020;36(12):1847. link
  2. [2]Otto CM, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease. Circulation 2021;143:e72. link
  3. [3]Granger CB, et al. ARISTOTLE: Apixaban versus warfarin in AF (less major and GI bleeding). NEJM 2011;365:981. link
  4. [4]Patel MR, et al. ROCKET-AF: Rivaroxaban versus warfarin in nonvalvular AF. NEJM 2011;365:883. link
  5. [5]Giugliano RP, et al. ENGAGE AF-TIMI 48: Edoxaban versus warfarin in AF (avoid if CrCl >95). NEJM 2013;369:2093. link
  6. [6]Connolly SJ, et al. RE-LY: Dabigatran versus warfarin in AF (dyspepsia; MI signal at 150 mg). NEJM 2009;361:1139. link
  7. [7]Lopes RD, et al. AUGUSTUS: Apixaban vs VKA and aspirin vs placebo after ACS/PCI in AF. NEJM 2019;380:1509. link
  8. [8]Eikelboom JW, et al. RE-ALIGN: Dabigatran versus warfarin with mechanical heart valves (stopped for harm). NEJM 2013;369:1206. link
  9. [9]Agnelli G, et al. Caravaggio: Apixaban for cancer-associated VTE (no excess GI bleeding). NEJM 2020;382:1599. link
  10. [10]Young AM, et al. SELECT-D: Rivaroxaban in cancer-associated VTE (more GI/GU bleeding). J Clin Oncol 2018;36:2017. link
  11. [11]Raskob GE, et al. Hokusai VTE Cancer: Edoxaban for cancer VTE (parenteral lead-in; more GI bleeding). NEJM 2018;378:615. link
  12. [12]Pollack CV, et al. RE-VERSE AD: Idarucizumab for dabigatran reversal. NEJM 2017;377:431. link
  13. [13]Pengo V, et al. TRAPS: Rivaroxaban vs warfarin in triple-positive antiphospholipid syndrome (stopped for excess events). Blood 2018;132:1365. link
  14. [14]Lee AYY, et al. CLOT: LMWH versus warfarin for cancer-associated thrombosis. NEJM 2003;349:146. link
  15. [15]Martin KA, et al. Use of DOACs at extremes of body weight — ISTH SSC guidance update. J Thromb Haemost 2021;19:1874. link
  16. [16]Ontario Drug Benefit (ODB) e-Formulary — as of the July 2024 update all four DOACs are General Benefit for AF/VTE (warfarin general benefit). Confirm live before counselling on coverage. link
  17. [17]Van Gelder IC, et al. 2024 ESC Guidelines for the management of atrial fibrillation (uses CHA₂DS₂-VA — drops the sex point). Eur Heart J 2024;45:3314. link
  18. [18]2025 ESC/EACTS Guidelines for the management of valvular heart disease (replaces 2021). Eur Heart J 2025;46:4635. link
  19. [19]Levine GN, et al. Management of Patients With Left Ventricular Thrombus: AHA Scientific Statement. Circulation 2022;146:e205. link
  20. [20]Guimarães HP, et al. RIVER: Rivaroxaban in patients with a bioprosthetic mitral valve and AF (non-inferior). NEJM 2020;383:2117. link
  21. [21]RIVAWAR: Rivaroxaban versus warfarin for LV thrombus (largest RCT to date; faster early resolution, non-inferior). JACC Advances 2025. link
  22. [22]Stevens SM, et al. Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline. Chest 2021;160:e545. link
  23. [23]Ortel TL, et al. ASH 2020 guidelines for management of VTE (treatment); Lyman GH, et al. ASH 2021 guidelines for VTE in cancer. Blood Adv 2020;4:4693 / 2021;5:927. link
  24. [24]Zuily S, et al. Use of DOACs in thrombotic antiphospholipid syndrome — ISTH SSC guidance. J Thromb Haemost 2020. link
  25. [25]Thrombosis Canada — clinical guides (AF stroke prevention, DVT/PE treatment, cancer and thrombosis, antiphospholipid syndrome, prosthetic valves; drug guides refreshed to 2025). link
  26. [26]Tektonidou MG, et al. EULAR recommendations for the management of antiphospholipid syndrome in adults. Ann Rheum Dis 2019;78:1296. link
  27. [27]TAVI antithrombotics: GALILEO (rivaroxaban+ASA harm; NEJM 2020;382:120) and POPular TAVI (ASA alone < DAPT bleeding; NEJM 2020;383:1447). link