Winpatrol is designed more to complement you AV and AS programs.
I use both Winpatrol and Defender + UAC is up and running. Winpatrol has some cool features that Defender doesn't have. Plus it's very cool that you can see HijackThis logs, hidden files, ActiveX, IE Helpers, registered file types, secret startup locations etc. all in one program. Damn usefull for any malware fighter is also their PLUS knowledgebase.
A bit off-topic but i have something for my buddy Tech to try out. And anyone else using Vista that wants a different and better UAC and like me doesn't want to wait for Windows 7 to come out before they get it. Symantec(your favorite company Tech

) released this UAC tool recently, don't know if you tried it yet but i will just say that this is how UAC should have looked like in the first place.
@Tech: You're gonna love this one trust me

Description:
User Account Control (UAC) is a new security feature in Microsoft Windows Vista that changes the architecture of the access token creation process and prevents users from logging on with full administrative rights.
While the intent of this feature may have been enhanced security, all too often users need administrative rights for tasks like installing/updating programs, and many software applications need access to run properly.
The User Account Control tool has been designed to replace the Vista UAC, to simultaneously make your system more secure while significantly improving user-friendliness.
By default, any application launched by an administrator is running with a filtered, standard user access token. When the administrator attempts to perform a task, the UAC prompts the user to approve the action. This can lead to poor user experiences because the prompts can be slow to display, and appear frequently and without warning. What’s more, because the UAC may give a false sense of security since other processes can still access the desktop, it actually raises security concerns.
The net effect is that many users find the UAC security clearance and prompting process annoying, especially those who are a computer’s only user and have all the latest Norton Internet Security software installed and updated.
The User Account Control tool will collect user input as well as information on applications causing prompts. The data will be processed to improve the comprehensiveness and robustness of the white list, which will be updatable while running the tool online.Link:
Norton UACTell me what you think people ?

P.S: Both 32bit and 64bit versions are available

EDIT: Screenshot:
