This article comments on a study in this issue which examined if idraparinux was non-inferior to oral vitamin K antagonists in the prevention of thromboembolism in patients with atrial fibrillation. The trial was forced to stop early due to excessive bleeding in those getting the idraparinux which the author says is a step sideways for research into a new class of anticoagulants. The author examines why an alternative for vitamin K antagonists is being sought. This trial was the third recent unsuccessful attempt to replace the use of warfarin for atrial fibrillation.
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