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Dabigatran has significantly lower bleeding rates compared with warfarin in patients with atrial fibrillation

Large trials have established that non-vitamin K antagonist oral anticoagulants are as effective as warfarin in preventing ischaemic stroke.

Atrial fibrillation is associated with an increased risk of ischaemic stroke and mortality.

In the past five years, large randomised trials have established that non-vitamin K antagonist oral anticoagulants (novel oral anticoagulants (NOACs)) are as effective as warfarin in preventing ischaemic stroke, but also substantially reduce the risk of associated intracranial haemorrhage.

Guidelines now recommend NOACs as first choice of drug. While meticulous dose adjustments are not required for NOACs as they are for warfarin, a clinical evaluation of appropriate dose is still necessary. Age and chronic kidney disease in patients with atrial fibrillation increase the risk of bleeding during anti-thrombotic treatment.

Older patients with atrial fibrillation were included in early trials but comprised only a small proportion of the patient populations. This study looked at 55,644 patients (average age 73.9) with

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