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In the large RE-LY study of patients with atrial fibrillation at risk for stroke, the novel oral thrombin inhibitor dabigatran (Pradaxa) reduced stroke with similar bleeding risk or reduced bleeding with a similar risk for stroke as compared with warfarin, depending on the dose used (JW Cardiol Sep 1 2009). But how does dabigatran compare with warfarin in high-risk patients with histories of stroke and transient ischemic attack (TIA)?
In a subgroup analysis of 3623 patients followed for a median of 2 years, the annual rate of stroke or systemic embolism was 2.78% in the warfarin group as compared with 2.32% and 2.07% in the 110-mg and 150-mg dabigatran dose groups, although neither comparison with warfarin was statistically significant. Howe…