IC: Antithrombics and anticoagulants are common therapies for those with AF and there are a few NOAC. What are your opinions on the NOAC therapies? Which ones do you see becoming more widely implemented in practice?
　　IC:对于房颤患者而言，抗栓及抗凝是非常普通的治疗方式，而NOAC的使用较为少见，您如何看待NOAC疗法？您认为哪种疗法将在临床实践中普遍应用？
　　Dr. Johnston: Warfarin is not a great drug， but for some it works well. For those patients， it is no surprise that they are continued on warfarin. Also， the new drugs are expensive， so they are factoring that into their decision on whether or not to switch. However， warfarin is a pain to use. The blood draws that are required for monitoring， the changes that happen with various drugs and diet， it can make your blood too thin or not thin enough， it is a hassle to use. I suspect that ultimately these new drugs will replace warfarin. How long that takes and which specific drug wins out， or if there are different choices for different countries or different patients. I think it just to early to say. It will take time and it should， as we have people who are doing quite well on warfarin， and the justification for switching will be lower. Ultimately， warfarin as a drug will die. It may be 10 years or 20， but it will not be 2， and probably not 5.
　　Dr. Johnston:华法林并非一种伟大的药物，但它对部分患者疗效显著，因此对于这类患者持续使用华法林我并不会感到奇怪。而新的药物费用昂贵，患者必须把这一因素考虑在内，以决定是否更换治疗药物。然而，华法林也给患者带来了苦恼。患者需接受血液监测，随着服用药物的不同及饮食的改变，患者的凝血功能将减弱或亢进，难以发挥正常功能。我认为，新型药物最终将取代华法林。至于要花费多次时间，最终哪种新药将脱颖而出，或者是否不同的国家、不同的患者会有不同的选择，现在回答还为时尚早。这一时间将会很长，因为华法林对部分人群的疗效理想，这使得它被替换的理由不明显。但最终，华法林仍将被淘汰，这个时间可能是10年或20年，但不会是2年或5年。
　　IC: One last question， would you agree that AC remains generally underused? What would be causes behind this?
　　IC:最后一个问题，您是否认同阿司匹林与氯吡格雷的联合治疗并未被充分利用，造成这一现象的原因是什么？
　　Dr. Johnston: AC is definitely underused in clinical practice. There are many studies that have shown that and there are many patients that are not receiving AC therapy that， either because they do not want to be troubled by it， or more commonly， they or their doctors are overly concerned by the risks and are not aware that the benefits far outweigh the risks in many patients. Various studies have suggested that under treatment is common. We could treat at least twice the number of patients we are currently treating. In China， that disconnect is even greater. The opportunity in China is even greater. While AF may be less common cause of stroke in China， but is in-patients with AF have tremendous opportunity to use AC.
　　Dr. Johnston:在临床实际中，阿司匹林与氯吡格雷的联合治疗并未充分使用，这一点非常明确。多项研究显示，许多患者并未接受阿司匹林与氯吡格雷的治疗。这一方面或许是因为患者觉得服药很麻烦，但更多的原因是医生过于担心阿司匹林与氯吡格雷所带来的风险，而忽视了对许多患者而言，其获益明显高于风险。不同的研究显示，阿司匹林与氯吡格雷联合是一种常见的治疗方法，需要接受这种治疗的患者数量应该是目前患者的2倍。在中国，这种断档现象更明显，同时机会也更多。虽然中国的房颤患者罹患卒中的几率较小，但实际上这类患者更应该时候用阿司匹林和氯吡格雷。