I think warfarin is on its way out. We now  have new oral anticoagulants that can be  given in fixed doses， produce a consistent and predictable anticoagulant response and don蒸 require routine coagulation monitoring. In the RELY trial， one such agent， dabigatran etexilate， when given at 150 mg twice daily doses， was superior to warfarin for stroke prevention in patients with atrial fibrillation. Results of the ROCKET atrial fibrillation trial shows that rivaroxaban also is at least as good if not better than warfarin for stroke prevention in very high risk patients with atrial fibrillation. I think we are going to see a gradual replacement of warfarin  with these new agents in the next 5 years .

    华法林正在逐渐淡出。目前，剂量固定、疗效持续且可预测的、无需常规监测的新型口服抗凝药物已被研制出。RELY试验显示，较之华法林，房颤患者服用达比加群酯150 mg Bid 可达到更好的卒中预防效果。ROCKET房颤研究提示，在极高危的房颤患者中，利伐沙班在卒中预防方面至少等同于华法林。未来5年，华法林将逐步被淘汰，由这些新型抗凝药物取而代之。

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