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Antithrombotic therapy with the oral anticoagulant warfarin is a well-established, reasonably safe, effective way to significantly reduce risk for embolic stroke in patients with atrial fibrillation. However, the therapy increases the risk for major intracranial hemorrhage and internal hemorrhage. It is currently cumbersome, requiring frequent blood tests and dose adjustments. Even under the best conditions, patients with atrial fibrillation receiving warfarin are sometimes out of the therapeutic range (international normalized ratio [INR], 2–3).
The direct thrombin inhibitor dabigatran etexilate, currently available in Europe and Canada, is a potential alternative to warfarin. Researchers conducted this large, manufacturer-supported, random…