Ximelagatran vs Warfarin for Stroke Prevention in Patients With Nonvalvular Atrial Fibrillation

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Abstract
Nonvalvular atrial fibrillation is implicated in nearly 15% of strokes.1 By meta-analysis of 6 randomized trials, dose-adjusted warfarin decreases stroke risk by 62%.2,3 In practice, the risk of bleeding limits treatment with warfarin, particularly among the elderly. Variability of anticoagulation intensity from interactions with foods and medication4 necessitates frequent monitoring and dose adjustments yet leaves patients outside the therapeutic range almost half the time.5,6 Underuse of warfarin in patients with atrial fibrillation at high risk of bleeding5,6 calls for safer, more dependable alternatives.7,8