Response to Letter Regarding Article, “Ischemic Stroke and Intracranial Hemorrhage With Aspirin, Dabigatran, and Warfarin: Impact of Quality of Anticoagulation Control”

We face the same challenge as Dr Feng et al1 in managing Chinese patients with atrial fibrillation (AF). Despite a lower prevalence, AF remains a major health threat, affecting >4 million people in Mainland China. Warfarin therapy is the cornerstone in AF management, which reduces ischemic events by two thirds when good time in therapeutic range can be achieved. However, its use has been disturbingly low among Chinese patients ranging from 5% to 20%. Warfarin is commonly been blamed as the root of the problem. In our study involving a real-world cohort of 8754 Chinese patients with AF, the time in therapeutic range, a measure of the quality of anticoagulation, is embarrassingly low, 38.8%.2 The poor time in treatment range is …