Dabigatran versus Warfarin in Patients with Atrial Fibrillation

In a large, randomized trial, two doses of the direct thrombin inhibitor dabigatran were compared with warfarin in patients who had atrial fibrillation and were at risk for stroke. At 2 years, the 110-mg dose of dabigatran was found to be noninferior, and the 150-mg dose superior, to warfarin with respect to the primary outcome of stroke or systemic embolism. At 2 years, the 110-mg dose of dabigatran was found to be noninferior, and the 150-mg dose superior, to warfarin with respect to the primary outcome of stroke or systemic embolism. Atrial fibrillation increases the risks of stroke and death. Vitamin K antagonists, such as warfarin, reduce the risks of stroke and death but increase the risk of hemorrhage as compared with control therapy. 1 Therefore, warfarin is recommended for patients who have atrial fibrillation and are at risk for stroke. 2 Vitamin K antagonists are cumbersome to use, because of their multiple interactions with food and drugs, and they require frequent laboratory monitoring. Therefore, they are often not used, and when they are, rates of discontinuation are high. 3 , 4 Many patients receiving warfarin still have inadequate anticoagulation. 5 Thus, there is a need . . .