We appreciate the interest of Tan and Lip in our article. We agree that the role of antiplatelet therapy may be different in arterial compared with venous disorders, potentially due to differences in white and red thrombi. The 2 studies cited by Tan and Lip were not published at the time our review was written, but we agree that these studies are important. We eagerly await the results of ongoing randomized clinical trials of patients with atrial fibrillation such as the Atrial Fibrillation Clopidogrel Trials with Irbesartan for Prevention of Vascular Events (ACTIVE) trial, comparing clopidogrel plus aspirin with warfarin therapy, and the Stroke Prophylaxis Using an Oral Thrombin Inhibitor in Atrial Fibrillation (SPORTIF) V trial, testing ximelagatran vs warfarin therapy. In the meantime, we concur that anticoagulation remain the current gold standard for patients with atrial fibrillation and also for thrombosis, at least in patients who are candidates for this form of therapy.
Bhatt DL, Francis GS. Red vs White Thrombi: Treating the Right Clot Is Crucial—Reply. Arch Intern Med. 2003;163(20):2534-2535. doi:10.1001/archinte.163.20.2534-a