What were the results of the Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE W)?
The Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE W) found that dual antiplatelet therapy (DAPT) decreased the risk of stroke compared to aspirin monotherapy, but the major bleeding rates with aspirin-clopidogrel were comparable to rates seen with warfarin (approximately 2% per year). Additionally, when comparing warfarin to DAPT, warfarin was associated with a 39% relative risk reduction (95% CI, 22-52) in strokes. Furthermore, several NOACs that directly inhibit thrombin (factor IIa) or activated factor X (factor Xa) have been approved as alternatives to VKAs for stroke prevention in AF.