Warfarin in the Prevention of Stroke Associated with Nonrheumatic Atrial Fibrillation — NEJM | Heart and Vascular Health | Scoop.it

20 years ago today the SPINAF trial was published.  This was one of the last studies to compare warfarin to placebo in atrial fibrillation (Afib)  for the prevention of stroke.  For the lsat 20 years warfarin has been the standard of care.  Anticoagulants (blood thinners) prevent stroke in Afib.  After this there were only a few more studues that were done comparing warfarin to placebo or aspirin (SPAF-II in 1994)  because it was felt to not be ethical since the benefits of warfarin are so clear for stroke prevnetion.  

AIn teh US, we've had only warfarin (coumadin) until 2 years ago (10/2010) when the first of the novel oral anticoagulants (NOACs) were introduced.  Pradaxa (dabigatran) and Xarelto (rivaroxaban) are now available in the US.  We expext Eliquis (apixiban) in 2013 with others to follow.