A recent study in Hong Kong compared warfarin and dabigatran in preventing thromboembolism in AF patients with moderate-to-severe MS and concluded that DOACs demonstrate greater efficacy.84 Furthermore, an ongoing clinical trial in Korea is investigating the long-term use of oral factor Xa inhibitors compared to VKAs following mechanical aortic valve replacement.85 However, the safety and efficacy of DOACs as an alternative to warfarin in patients with AF and moderate or severe MS remains uncertain due to the absence of clinical trial data. The gene discussed is F10; the disease is Thromboembolism.