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Oral anticoagulation therapy reduces the risk for stroke in patients with atrial fibrillation, but warfarin use can be inconvenient and increases bleeding risk. Given these concerns, researchers enrolled patients with atrial fibrillation and at least one stroke risk factor in an open-label randomized trial comparing dual antiplatelet therapy (75 mg of clopidogrel plus 75–100 mg of aspirin daily) with oral anticoagulation therapy, which is usually warfarin (target INR, 2–3).
The trial, known by the acronym ACTIVE W and funded by the makers of clopidogrel, was stopped after enrolling 6706 patients (median follow-up, 1.3 years) because anticoagulation was clearly superior to dual antiplatelet therapy. The anticoagulation group had significantly…