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Warfarin reduces the risk for stroke or systemic embolism in patients with atrial fibrillation (AF). However, warfarin has a narrow therapeutic window and requires frequent blood draws and dietary restrictions, so only about 50% of patients eligible for the drug receive it. Ximelagatran, a direct thrombin inhibitor and the first warfarin alternative to undergo a major trial (JW Cardiol Mar 25 2005), was associated with adverse hepatic findings. However, dabigatran, another direct thrombin inhibitor, and rivaroxaban, a factor Xa inhibitor, both lowered the risk for systemic embolism and major bleeding without adverse effects (JW Cardiol 2009 Sep 1 and Aug 10 2011), and dabigatran is now FDA approved for stroke prevention in AF. Now apixaban,…