Patients with AF NA NA C-statistic NRI, IDI, DCA Absolute rates of ischemic stroke and TE Cohort studies Clinical prediction rules Antithrombotic Therapy 2.1 Patients with nonvalvular AF What are the bene ts and risks of different stroke prevention strategies? Patients with nonrheumatic AF - Low risk - Intermediate risk - High risk (including prior stroke) VKA No VKA - Death - All stroke - Ischemic stroke - Systemic embolism - Intracranial hem- orrhage (subdural, subarachnoid, and intracerebral) - Major extracranial hemorrhage - MI - Vascular death SR RCTs (Continued) Evidence-Based Medicine [ # C H E S T N O V E M B E R ] TABLE 1 ] (Continued) Section Question Patients Intervention Control Outcomes Methodology 2.1 Patients with nonrheumatic AF As above Antiplatelet drug (aspirin or other) No antiplatelet drug - Death - All stroke - Ischemic stroke - Systemic embolism - Intracranial hemorrhage (subdural, sub- arachnoid, and intracerebral) - Major extracranial hemorrhage - MI - Vascular death SR RCTs As above VKA Antiplatelet drug (aspirin or other) - Death - All stroke - Ischemic stroke - Systemic embolism - Intracranial hem- orrhage (subdural, subarachnoid, and intracerebral) - Major extracranial hemorrhage - MI - Vascular death SR RCTs As above Adjusted dose VKA Fixed minidose or low-intensity VKA  aspirin - Death - All stroke - Ischemic stroke - Systemic embolism - Intracranial hemorrhage (sub- dural, subarach- noid, and intracerebral) - Major extracranial hemorrhage - MI - Vascular death (Continued) chestjournal.org TABLE 1 ] (Continued) Section Question Patients Intervention Control Outcomes Methodology As above Clopidogrel aspirin Aspirin - Death - All stroke - Ischemic stroke - Systemic embolism - Intracranial hem- orrhage (subdural, subarachnoid, and intracerebral) - Major extracranial hemorrhage - MI - Vascular death SR RCTs As above NOACs VKA - Death - All stroke - Ischemic stroke - Systemic embolism - Intracranial hem- orrhage (subdural, subarachnoid, and intracerebral) - Major extracranial hemorrhage - MI - Vascular death SR RCTs Cohort studies As above NOAC Aspirin - Death - All stroke - Ischemic stroke - Systemic embolism - Intracranial hem- orrhage (subdural, subarachnoid, and intracerebral) - Major extracranial hemorrhage - MI - Vascular death SR RCTs Cohort studies (Continued) Evidence-Based Medicine [ # C H E S T N O V E M B E R ] TABLE 1 ] (Continued) Section Question Patients Intervention Control Outcomes Methodology As above Device therapy (WATCHMAN, PLAATO) VKA - Death - All stroke - Ischemic stroke - Systemic embolism - Intracranial hem- orrhage (subdural, subarachnoid, and intracerebral) - Major extracranial hemorrhage - MI - Vascular death - cardiac tamponade SR RCTs Cohort studies As above Nonpharmacologic therapies - Removal or liga- tion of left atrial appendage - Surgical or cath- eter ablation - Maze procedure VKA - Death - All stroke - Ischemic stroke - Systemic embolism - Intracranial hem- orrhage (subdural, subarachnoid, and intracerebral) - Major extracranial hemorrhage - MI - Vascular death - procedural / surgi- cal complications SR RCTs Cohort studies 2.2 Patients with valvular AF What are the bene ts and risks of different stroke prevention strategies? 