Table 2. Recommendations about the selection of right NOAC, regarding the underlying pathology or risk factor.

Underlying condition-risk factor	Indicated NOAC	Comment
ACS: acute coronary syndromes; GI: gastrointestinal.
High bleeding risk (HAS BLED > 3) or history of hemorrhage	Dabigatran 110 mg or Apixaban or Edoxaban 30 mg	Agents with lower incidence of bleeding should be considered. Apixaban, low-dose dabigatran and low-dose edoxaban have safer profile.[27,29,64]
History of gastrointestinal bleeding	Apixaban or edoxaban Dabigatran 110 mg	Apixaban and edoxaban have been associated with less GI bleeding.[65] Low-dose dabigatran could act as alternate. Rivaroxaban should be avoided.[66]
History of intracranial bleeding	Dabigatran 110 mg or Apixaban or Edoxaban 30 mg	Rivaroxaban should be avoided as it has been associated with higher risk of intracranial bleeding.[67]
Conservative management of ACS	Apixaban	Apixaban has been studied in post-ACS patients, who were not performed PCI. It was shown that apixaban with an antiplatelet agent, mainly clopidogrel, were more safe and equivalently effective as VKAs at least for 6 months therapy.[68]
Stroke while on anticoagulation	Dabigatran 150 mg	High-dose dabigatran has been proposed for the prevention of recurrent, ischemic or hemorrhagic, stroke.[69]
High ischemic risk	Dabigatran 150 mg	Patients in prothrombotic state are benefited by high dose dabigatran.[70]
Renal impairment	Dabigatran or rivaroxaban or edoxaban	None NOAC should be administered for patients with eGFR < 15 mL/min per 1.73 m 2. Careful administration should be followed in patients with eGFR < 60 mL/min per 1.73 m 2. Rivaroxaban and dabigatran could present a safer and renoprotective profile, while larger, prospective studies should be conducted.[46,71]
Elderly (> 80 years old) or high frailty score	Apixaban or Edoxaban, regardless the dose, and dabigatran 110 mg	Patients >80 years old are more prone to face intracranial hemorrhage, so apixaban and edoxaban are recommended as safe solutions. [25,26] Low-dose dabigatran is also safe for these populations.[29]
Feeding through nasogastric tube	Rivaroxaban	Rivaroxaban has been studied more comprehensively, when is administered as oral solution or crushed, followed by apixaban.[72,73]
Poor compliance	Rivaroxaban or Edoxaban 60 mg	Rivaroxaban and Edoxaban 60 mg are the only with once-daily dose.[23,26]
Need for reversal agent	Dabigatran	All the NOACs have an reversal agent, but idarucizumab has been widely available and more clinical experience about the specific agent exists.[30]
Dyspepsia	Apixaban or Rivaroxaban or Edoxaban 60 mg	Dabigatran has been associated with gastrointestinal adverse effects. Food intake and gastroprotection could relieve dyspepsia.[74]
Asian patients	Apixaban or Dabigatran 110 mg or Edoxaban	Asian patients are more susceptible to major hemorrhages, so agents associated with lower bleeding risk should be considered.[75]