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Warfarin has a long history of success in the prevention of thromboembolism in patients with atrial fibrillation (AF) and the treatment of deep venous thrombosis and pulmonary embolism; the drug is also used to prevent both venous and arterial clots and to treat several other conditions (e.g., anticardiolipin antibody syndrome). However, warfarin requires frequent monitoring of the international normalized ratio (INR) and dose adjustment; even with meticulous care, warfarin recipients often have INRs outside of the narrow therapeutic window.
Indeed, many pharmaceutical companies have been hard at work on replacements for warfarin. Warfarin is an inhibitor of thrombin synthesis. Most of the drugs currently under evaluation for prev…