Should ximelagatran replace warfarin for stroke prevention in patients with atrial fibrillation?
Geoffrey A Donnan* and John V Ly
Correspondence *National Stroke Research Institute, Austin Health, University of Melbourne, 300 Waterdale Rd, Heidelberg Heights, Victoria 3081, Australia
Email gdonnan@unimelb.edu.au
This article has no abstract so we have provided the first paragraph of the full text.
AF is a unique and major risk factor for ischemic stroke, with a relative risk of about 5–7% per year.1 Importantly, warfarin has been shown to be highly effective in reducing fatal and nonfatal stroke by 62%, with an absolute risk reduction of 2.7% per year;2 however, despite its efficacy, there are several problems with warfarin usage. First, warfarin therapy requires rigorous anticoagulant monitoring because of the narrow therapeutic window and its potential interaction with drugs and foods—although constant monitoring might actually increase compliance. Second, the potential risks of bleeding are significant. Consequently, there is resistance to warfarin use by physicians and patients, leading to a less than optimum uptake of this drug.
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