Atrial Fibrillation: Should I Take Warfarin to Prevent Stroke?

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Atrial Fibrillation: Should I Take Warfarin to Prevent Stroke?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Atrial Fibrillation: Should I Take Warfarin to Prevent Stroke?

Get the facts

Your options

  • Take the anticoagulant medicine warfarin to reduce the risk of stroke.
  • Don't take warfarin. You may try other medicines.

Key points to remember

  • Atrial fibrillation increases your risk of stroke. High blood pressure, heart failure, a previous stroke, or being 75 or older can also put you at high risk for stroke. Taking the anticoagulant warfarin lowers that risk.
  • Warfarin may not be safe for you if you fall often, can't control your blood pressure, have stomach bleeding, or drink large amounts of alcohol.
  • Dabigatran (Pradax) is a newer anticoagulant (blood thinner) medicine that can be used instead of warfarin to help prevent stroke in people who have atrial fibrillation. It may be a good choice if you cannot take warfarin safely.
  • ASA may be a good choice if you are young and have no other heart or health problems or if you can't take an anticoagulant safely. ASA doesn't work as well as an anticoagulant to reduce your stroke risk. But ASA is less likely to cause bleeding problems.
  • When you take warfarin, you need to have regular blood tests to make sure that you are taking the right dose. You'll need to take enough medicine to lower your risk of stroke, but not so much that you have a problem with bleeding.
FAQs

What are anticoagulants?

Anticoagulants, such as warfarin, are medicines that help prevent blood clots. Blood clots can lead to stroke. These medicines are often called blood thinners, but they don't actually thin your blood. Instead, they increase the time it takes for a blood clot to form.

Why is it important to take medicine if you have atrial fibrillation?

Atrial fibrillation increases your risk of stroke. Taking warfarin can reduce that risk.

The risk of stroke isn't the same for everyone who has atrial fibrillation. But people who have atrial fibrillation are 5 times more likely to have a stroke than are people who don't have atrial fibrillation.1

Warfarin can help protect against stroke, if you can take it safely. Your doctor may recommend that you take warfarin if you are at high risk for stroke based on your risk factors. Anything that increases your risk for a disease or problem is called a risk factor. The more risk factors you have, the greater your chance of having a stroke.

Risk factors for stroke besides atrial fibrillation include:

If you are 55 or older, you can find out your risk of having a stroke in the next 5 years with this Interactive Tool: What Is Your Risk for a Stroke if You Have Atrial Fibrillation?

What are the risks of taking warfarin?

When you take warfarin, your blood clots more slowly than normal. This increases your risk of bleeding problems in and around the brain, bleeding in the stomach and intestines, bruising and bleeding if you are hurt, and serious skin rash.

Some people can't take warfarin, because they have a higher risk of having a serious problem if bleeding occurs. You shouldn't take warfarin if:

  • You have blood in your stool for no clear reason.
  • You can't control your blood pressure.
  • You fall often.
  • You won't be able to take the steps needed to be safe when you take warfarin.
  • You drink large amounts of alcohol.
  • You aren't able or willing to have regular blood tests, which make sure that you are taking the right dose.

When you take an anticoagulant, also called a blood thinner, you need to take extra steps to avoid bleeding problems such as preventing falls and injuries. If you take warfarin, you also get regular blood tests and watch how much vitamin K you eat or drink. For more information about safety and warfarin, see:

Click here to view an Actionset. Warfarin: Taking Your Medicine Safely.

If you have atrial fibrillation and are pregnant or are thinking about getting pregnant, talk with your doctor before taking warfarin. It may cause birth defects and problems during pregnancy.

How well does warfarin work?

Warfarin lowers the risk of stroke in people who have atrial fibrillation. But how much your risk will be lowered depends on how high your risk was to start with. Not everyone with atrial fibrillation has the same risk of stroke. It's a good idea to talk with your doctor about your risk.

You will want to weigh the benefits of reducing your risk of stroke against the risks of taking warfarin. Warfarin works well to prevent stroke. But warfarin also increases the risk of bleeding. Each year about 2 out of 100 people who take warfarin will have a problem with severe bleeding, and 98 will not.2 But this is an average risk. Your own risk may be higher or lower than average based on your own health.

What can you do instead of taking warfarin?

Dabigatran

Dabigatran (Pradax) is a newer anticoagulant (blood thinner) medicine that can be used instead of warfarin to help prevent stroke in people who have atrial fibrillation. Dabigatran works as well as warfarin to prevent blood clots and lower your risk of stroke. Like warfarin, how much your risk will be reduced depends on how high your risk was to start with.

Dabigatran may be a good choice if you cannot take warfarin safely or you have having problems, like side effects, with warfarin. But dabigatran costs more than warfarin.

Like warfarin, dabigatran can cause serious bleeding. Each year about 3 out of 100 people who take dabigatran have a problem with severe bleeding.3 Your own risk of bleeding may be higher or lower than average, based on your own health. Dabigatran is newer medicine so doctors do not yet know if it has any other long-term side effects.

Dabigatran works differently from warfarin to prevent blood clots. So some of the precautions and safety tips for dabigatran are different from those for warfarin. Like warfarin, you need to take extra steps to prevent bleeding. These extra steps include preventing falls and injuries. But unlike warfarin, you do not need regular blood tests and you do not need to watch how much vitamin K you eat or drink.

ASA and other antiplatelet medicines

ASA may be a good choice if you are young and have no other heart or health problems or if you can't take an anticoagulant (blood thinner) safely. ASA doesn't work as well as an anticoagulant, such as warfarin, to reduce your stroke risk. But ASA is less likely to cause bleeding problems.

If you are at low risk for stroke or can't take warfarin, your doctor may recommend that you take ASA. ASA is an antiplatelet medicine. It decreases the risk of blood clotting by preventing the smallest blood cells (platelets) from sticking together and making a clot.

ASA lowers the risk of stroke in people who have atrial fibrillation but not nearly as much as an anticoagulant, such as warfarin, does. How much your risk will be reduced depends on how high your risk was to start with.

ASA is less likely than an anticoagulant to cause bleeding problems. Bleeding that is bad enough to need treatment in a hospital happens in 1 or 2 out of 1,000 people who take ASA.4 This means that 998 or 999 out of 1,000 people who take ASA don't have serious bleeding.

Other antiplatelet medicines, such as clopidogrel (Plavix), may be used. Your doctor may have you take them with ASA or instead of ASA. When ASA and clopidogrel are used together, they may reduce the risk for stroke more than ASA alone. But this combination is also more likely to cause bleeding than ASA alone.

Why might your doctor recommend taking warfarin?

Your doctor may advise you to take warfarin if:

  • Your risk of stroke is high and warfarin is the best treatment for you.
  • You are able to take warfarin safely.
  • You are willing and able to get regular blood tests.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Take warfarin to reduce the risk of stroke Take warfarin to reduce the risk of stroke
  • You take a pill every day.
  • You have regular blood tests to make sure that you are taking the right dose.
  • Warfarin lowers the risk of stroke in people who have atrial fibrillation.
  • Warfarin increases your risk of bleeding problems.
  • Warfarin may cause birth defects if you take it while you are pregnant.
  • Warfarin lowers your risk, but you could still have a stroke.
Don't take warfarin Don't take warfarin
  • You may take another type of anticoagulant, dabigatran (Pradax), to lower your risk of stroke.
  • You may take ASA every day to reduce your risk of stroke.
  • You may try another antiplatelet medicine, such as clopidogrel (Plavix).
  • Dabigatran lowers the risk of stroke in people who have atrial fibrillation. It works as well as warfarin to reduce stroke risk.
  • ASA lowers the risk of stroke in people who have atrial fibrillation. But ASA doesn't work as well as warfarin to reduce stroke risk.
  • ASA is less likely than warfarin to cause bleeding problems.
  • You do not need regular blood tests.
  • You do not have to watch how much vitamin K you eat or drink.
  • If you have atrial fibrillation and don't take any medicine, you might have a stroke.
  • ASA can reduce your risk, but you could still have a stroke. Your risk of having a stroke is higher than it would be if you took an anticoagulant (blood thinner), such as warfarin.
  • Dabigatran can cause bleeding problems.
  • Dabigatran costs more than warfarin. And because it is a newer medicine, long-term side effects are not well known.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about taking warfarin

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I have other risk factors for stroke besides atrial fibrillation. My doctor and I decided that it is important for me to take warfarin to help reduce my risk for having a stroke.

Monty, age 72

I live on a ranch more than 150 kilometres from my doctor's office. I don't plan on checking in with him every week to have my blood tested. So I'm going to try a blood thinner that doesn't need regular blood testing.

Chuck, age 48

I am not overly concerned about bleeding problems from taking warfarin, and I am comfortable having my blood tested regularly to make sure the medications are working correctly.

Martha, age 64

I have a bleeding ulcer that I am caring for, so I am not a good candidate for blood thinners.

Geraldo, age 52

If you need more information, see the topic Atrial Fibrillation.

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take warfarin

Reasons not to take warfarin

I worry about my risk of stroke.

I think that my risk of stroke is low.

More important
Equally important
More important

I don't mind having regular blood tests.

I don't want to get my blood tested regularly.

More important
Equally important
More important

Lowering my risk of stroke is more important to me than the risk of a bleeding problem.

I'm more worried about my risk of a bleeding problem than my risk of stroke.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking warfarin

NOT taking warfarin

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

If you have atrial fibrillation, are you at higher risk of stroke than someone who does not have it?

  • YesYou're right. Atrial fibrillation increases your risk of stroke, but warfarin can reduce that risk.
  • NoSorry, that's not right. Atrial fibrillation increases your risk of stroke, but warfarin can reduce that risk.
  • I'm not sureIt may help to go back and read "Why is it important to take medicine if you have atrial fibrillation?" Atrial fibrillation increases your risk of stroke, but warfarin can reduce that risk.
2.

Is warfarin safe for everyone to take?

  • YesSorry, that's not right. Warfarin may not be safe for you if you fall often, can't control your blood pressure, have stomach bleeding, or drink large amounts of alcohol.
  • NoYou're right. Warfarin may not be safe for you if you fall often, can't control your blood pressure, have stomach bleeding, or drink large amounts of alcohol.
  • I'm not sureIt may help to go back and read "What are the risks of taking warfarin?" Warfarin may not be safe for you if you fall often, can't control your blood pressure, have stomach bleeding, or drink large amounts of alcohol.
3.

Does ASA work as well as warfarin to reduce the risk of stroke?

  • YesSorry, that's not right. ASA doesn't work as well as warfarin to reduce the risk of stroke, but it is less likely to cause bleeding problems.
  • NoYou are right. ASA doesn't work as well as warfarin to reduce your risk of stroke, but it is less likely to cause bleeding problems.
  • I'm not sureIt may help to go back and read "What can you do instead of taking warfarin?" ASA doesn't work as well as warfarin to reduce your risk of stroke, but it is less likely to cause bleeding problems.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits and References

Credits
CreditsHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Primary Medical ReviewerBrian D. O'Brien, MD - Internal Medicine
Specialist Medical ReviewerJohn M. Miller, MD - Electrophysiology

References
Citations
  1. Prevention of stroke in patients with atrial fibrillation (2009). Medical Letter on Drugs and Therapeutics, 51(1313): 41.
  2. Antiplatelet and anticoagulant drugs (2008). Treatment Guidelines From The Medical Letter, 6(69): 29–36.
  3. Dabigatran etexilate (Pradaxa)—A new oral anticoagulant (2010). Medical Letter on Drugs and Therapeutics, 52(1351): 89–90.
  4. Patrono C, et al. (2008). Antiplatelet drugs: American College of Chest Physicians evidence-based clinical practice guidelines (8th ed.). Chest, 133(6): 199S–233S.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Atrial Fibrillation: Should I Take Warfarin to Prevent Stroke?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the facts

Your options

  • Take the anticoagulant medicine warfarin to reduce the risk of stroke.
  • Don't take warfarin. You may try other medicines.

Key points to remember

  • Atrial fibrillation increases your risk of stroke. High blood pressure, heart failure, a previous stroke, or being 75 or older can also put you at high risk for stroke. Taking the anticoagulant warfarin lowers that risk.
  • Warfarin may not be safe for you if you fall often, can't control your blood pressure, have stomach bleeding, or drink large amounts of alcohol.
  • Dabigatran (Pradax) is a newer anticoagulant (blood thinner) medicine that can be used instead of warfarin to help prevent stroke in people who have atrial fibrillation. It may be a good choice if you cannot take warfarin safely.
  • ASA may be a good choice if you are young and have no other heart or health problems or if you can't take an anticoagulant safely. ASA doesn't work as well as an anticoagulant to reduce your stroke risk. But ASA is less likely to cause bleeding problems.
  • When you take warfarin, you need to have regular blood tests to make sure that you are taking the right dose. You'll need to take enough medicine to lower your risk of stroke, but not so much that you have a problem with bleeding.
FAQs

What are anticoagulants?

Anticoagulants, such as warfarin, are medicines that help prevent blood clots. Blood clots can lead to stroke. These medicines are often called blood thinners, but they don't actually thin your blood. Instead, they increase the time it takes for a blood clot to form.

Why is it important to take medicine if you have atrial fibrillation?

Atrial fibrillation increases your risk of stroke. Taking warfarin can reduce that risk.

The risk of stroke isn't the same for everyone who has atrial fibrillation. But people who have atrial fibrillation are 5 times more likely to have a stroke than are people who don't have atrial fibrillation.1

Warfarin can help protect against stroke, if you can take it safely. Your doctor may recommend that you take warfarin if you are at high risk for stroke based on your risk factors. Anything that increases your risk for a disease or problem is called a risk factor. The more risk factors you have, the greater your chance of having a stroke.

Risk factors for stroke besides atrial fibrillation include:

If you are 55 or older, you can find out your risk of having a stroke in the next 5 years with this Interactive Tool: What Is Your Risk for a Stroke if You Have Atrial Fibrillation?

What are the risks of taking warfarin?

When you take warfarin, your blood clots more slowly than normal. This increases your risk of bleeding problems in and around the brain, bleeding in the stomach and intestines, bruising and bleeding if you are hurt, and serious skin rash.

Some people can't take warfarin, because they have a higher risk of having a serious problem if bleeding occurs. You shouldn't take warfarin if:

  • You have blood in your stool for no clear reason.
  • You can't control your blood pressure.
  • You fall often.
  • You won't be able to take the steps needed to be safe when you take warfarin.
  • You drink large amounts of alcohol.
  • You aren't able or willing to have regular blood tests, which make sure that you are taking the right dose.

When you take an anticoagulant, also called a blood thinner, you need to take extra steps to avoid bleeding problems such as preventing falls and injuries. If you take warfarin, you also get regular blood tests and watch how much vitamin K you eat or drink. For more information about safety and warfarin, see:

Click here to view an Actionset. Warfarin: Taking Your Medicine Safely.

If you have atrial fibrillation and are pregnant or are thinking about getting pregnant, talk with your doctor before taking warfarin. It may cause birth defects and problems during pregnancy.

How well does warfarin work?

Warfarin lowers the risk of stroke in people who have atrial fibrillation. But how much your risk will be lowered depends on how high your risk was to start with. Not everyone with atrial fibrillation has the same risk of stroke. It's a good idea to talk with your doctor about your risk.

You will want to weigh the benefits of reducing your risk of stroke against the risks of taking warfarin. Warfarin works well to prevent stroke. But warfarin also increases the risk of bleeding. Each year about 2 out of 100 people who take warfarin will have a problem with severe bleeding, and 98 will not.2 But this is an average risk. Your own risk may be higher or lower than average based on your own health.

What can you do instead of taking warfarin?

Dabigatran

Dabigatran (Pradax) is a newer anticoagulant (blood thinner) medicine that can be used instead of warfarin to help prevent stroke in people who have atrial fibrillation. Dabigatran works as well as warfarin to prevent blood clots and lower your risk of stroke. Like warfarin, how much your risk will be reduced depends on how high your risk was to start with.

Dabigatran may be a good choice if you cannot take warfarin safely or you have having problems, like side effects, with warfarin. But dabigatran costs more than warfarin.

Like warfarin, dabigatran can cause serious bleeding. Each year about 3 out of 100 people who take dabigatran have a problem with severe bleeding.3 Your own risk of bleeding may be higher or lower than average, based on your own health. Dabigatran is newer medicine so doctors do not yet know if it has any other long-term side effects.

Dabigatran works differently from warfarin to prevent blood clots. So some of the precautions and safety tips for dabigatran are different from those for warfarin. Like warfarin, you need to take extra steps to prevent bleeding. These extra steps include preventing falls and injuries. But unlike warfarin, you do not need regular blood tests and you do not need to watch how much vitamin K you eat or drink.

ASA and other antiplatelet medicines

ASA may be a good choice if you are young and have no other heart or health problems or if you can't take an anticoagulant (blood thinner) safely. ASA doesn't work as well as an anticoagulant, such as warfarin, to reduce your stroke risk. But ASA is less likely to cause bleeding problems.

If you are at low risk for stroke or can't take warfarin, your doctor may recommend that you take ASA. ASA is an antiplatelet medicine. It decreases the risk of blood clotting by preventing the smallest blood cells (platelets) from sticking together and making a clot.

ASA lowers the risk of stroke in people who have atrial fibrillation but not nearly as much as an anticoagulant, such as warfarin, does. How much your risk will be reduced depends on how high your risk was to start with.

ASA is less likely than an anticoagulant to cause bleeding problems. Bleeding that is bad enough to need treatment in a hospital happens in 1 or 2 out of 1,000 people who take ASA.4 This means that 998 or 999 out of 1,000 people who take ASA don't have serious bleeding.

Other antiplatelet medicines, such as clopidogrel (Plavix), may be used. Your doctor may have you take them with ASA or instead of ASA. When ASA and clopidogrel are used together, they may reduce the risk for stroke more than ASA alone. But this combination is also more likely to cause bleeding than ASA alone.

Why might your doctor recommend taking warfarin?

Your doctor may advise you to take warfarin if:

  • Your risk of stroke is high and warfarin is the best treatment for you.
  • You are able to take warfarin safely.
  • You are willing and able to get regular blood tests.

2. Compare your options

  Take warfarin to reduce the risk of stroke Don't take warfarin
What is usually involved?
  • You take a pill every day.
  • You have regular blood tests to make sure that you are taking the right dose.
  • You may take another type of anticoagulant, dabigatran (Pradax), to lower your risk of stroke.
  • You may take ASA every day to reduce your risk of stroke.
  • You may try another antiplatelet medicine, such as clopidogrel (Plavix).
What are the benefits?
  • Warfarin lowers the risk of stroke in people who have atrial fibrillation.
  • Dabigatran lowers the risk of stroke in people who have atrial fibrillation. It works as well as warfarin to reduce stroke risk.
  • ASA lowers the risk of stroke in people who have atrial fibrillation. But ASA doesn't work as well as warfarin to reduce stroke risk.
  • ASA is less likely than warfarin to cause bleeding problems.
  • You do not need regular blood tests.
  • You do not have to watch how much vitamin K you eat or drink.
What are the risks and side effects?
  • Warfarin increases your risk of bleeding problems.
  • Warfarin may cause birth defects if you take it while you are pregnant.
  • Warfarin lowers your risk, but you could still have a stroke.
  • If you have atrial fibrillation and don't take any medicine, you might have a stroke.
  • ASA can reduce your risk, but you could still have a stroke. Your risk of having a stroke is higher than it would be if you took an anticoagulant (blood thinner), such as warfarin.
  • Dabigatran can cause bleeding problems.
  • Dabigatran costs more than warfarin. And because it is a newer medicine, long-term side effects are not well known.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

If you need more information, see the topic Atrial Fibrillation.

Personal stories about taking warfarin

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I have other risk factors for stroke besides atrial fibrillation. My doctor and I decided that it is important for me to take warfarin to help reduce my risk for having a stroke."

— Monty, age 72

"I live on a ranch more than 150 kilometres from my doctor's office. I don't plan on checking in with him every week to have my blood tested. So I'm going to try a blood thinner that doesn't need regular blood testing."

— Chuck, age 48

"I am not overly concerned about bleeding problems from taking warfarin, and I am comfortable having my blood tested regularly to make sure the medications are working correctly."

— Martha, age 64

"I have a bleeding ulcer that I am caring for, so I am not a good candidate for blood thinners."

— Geraldo, age 52

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take warfarin

Reasons not to take warfarin

I worry about my risk of stroke.

I think that my risk of stroke is low.

More important
Equally important
More important

I don't mind having regular blood tests.

I don't want to get my blood tested regularly.

More important
Equally important
More important

Lowering my risk of stroke is more important to me than the risk of a bleeding problem.

I'm more worried about my risk of a bleeding problem than my risk of stroke.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking warfarin

NOT taking warfarin

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. If you have atrial fibrillation, are you at higher risk of stroke than someone who does not have it?

  • Yes
  • No
  • I'm not sure
You're right. Atrial fibrillation increases your risk of stroke, but warfarin can reduce that risk.

2. Is warfarin safe for everyone to take?

  • Yes
  • No
  • I'm not sure
You're right. Warfarin may not be safe for you if you fall often, can't control your blood pressure, have stomach bleeding, or drink large amounts of alcohol.

3. Does ASA work as well as warfarin to reduce the risk of stroke?

  • Yes
  • No
  • I'm not sure
You are right. ASA doesn't work as well as warfarin to reduce your risk of stroke, but it is less likely to cause bleeding problems.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

Credits
ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Primary Medical ReviewerBrian D. O'Brien, MD - Internal Medicine
Specialist Medical ReviewerJohn M. Miller, MD - Electrophysiology

References
Citations
  1. Prevention of stroke in patients with atrial fibrillation (2009). Medical Letter on Drugs and Therapeutics, 51(1313): 41.
  2. Antiplatelet and anticoagulant drugs (2008). Treatment Guidelines From The Medical Letter, 6(69): 29–36.
  3. Dabigatran etexilate (Pradaxa)—A new oral anticoagulant (2010). Medical Letter on Drugs and Therapeutics, 52(1351): 89–90.
  4. Patrono C, et al. (2008). Antiplatelet drugs: American College of Chest Physicians evidence-based clinical practice guidelines (8th ed.). Chest, 133(6): 199S–233S.

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