It is imp
stroke who received high-quality vitamin K–antagonist therapy (approximately 1.1 to 1.3%).
For now, the weight of current evidence supports the view that patients with atrial fibrillation who are at moderate-to-high risk for stroke and for whom a vitamin K antagonist is suitable should be considered for high-quality vitamin K–antagonist therapy to maximize the prevention of thromboembolism with an acceptable risk of major bleeding. For patients with atrial fibrillation who are at moderate-to-high risk for stroke and absolutely
cannot tolerate a vitamin K antagonist those in whom high-quality anticoagulation is not achieved despite the best systematic efforts, or those who are at lower risk for stroke, the combination of clopidogrel and aspirin will most likely provide a net clinical benefit as compared with aspirin alone.
latest news:
Published at www.nejm.org August 30, 2009 (10.1056/NEJMoa0905561)
Dabigatran versus Warfarin in Patients with Atrial Fibrillation
In patients with atrial fibrillation, dabigatran given at a dose of 110 mg was associated with rates of stroke and systemic embolism that were similar to those associated with warfarin, as well as lower rates of major hemorrhage. Dabigatran administered at a dose of 150 mg, as compared with warfarin, was associated with lower rates of stroke and systemic embolism but similar rates of major hemorrhage.
达比加群（Dabigatran）是一种口服的直接凝血酶新抑制剂。是一种起效快的药物前体，日服2次，无需抗凝监测。
可以预测房颤的抗凝进入新的时代。
再次补充：2009.12月：Dabigatran在预防静脉血栓栓塞的效果上与华法令相同，出血率也相同，但是有不用检测凝血指标的优点。目前看来，房颤、深静脉血栓相关预防上，达比加群都完全可以替代华法令，效果和副作用好于或等于华法令，但是不用监测这一条就有很大优势。
不知道价钱如何。
高危：华法令》阿司匹林+波利维》阿司匹林
低危：阿司匹林
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