In AF patients requiring OAC presenting with an ACS, undergoing PCI/stenting, where bleeding risk is high (HAS-BLED 3), we suggest triple therapy for 1- 3 months, followed by dual therapy with OAC plus single antiplatelet (preferably clopidogrel) up to 12 months, following which OAC monotherapy can be used (Weak recommendation, low quality evidence). 27. In AF patients requiring OAC presenting with an ACS, undergoing PCI/stenting where bleeding risk is unusually high and thrombotic risk low, we suggest OAC plus single antiplatelet (preferably clopidogrel) for 6-9 months may be considered, following which OAC monotherapy can be used. (Weak recommendation, low quality evidence). Remark: Patients at unusually high bleeding risk may include patients with HAS-BLED $ 3 and recent acute bleeding event. High thrombotic risk may include those with left main stent, multivessel PCI/stenting, etc. 28. In AF patients with ACS or undergoing PCI in whom OAC is recommended, we suggest using VKA with TTR > 65-70% (INR range 2.0-3.0), or to use an NOAC at a dose licensed for stroke prevention in AF (Weak recommendation, low quality evidence). Remark: Only dabigatran 150 mg bid or (not licensed in USA) 110 mg bid or rivaroxaban 15mg qd are currently supported by clinical trial evidence. An NOAC based strategy has lower bleeding risk compared to a VKA- based strategy. 29. In AF patients in which aspirin is concomitantly used with OAC, we suggest a dose of 75-100 mg qd with concomitant use of PPI to minimize gastrointestinal bleeding (Weak recommendation, low quality evidence). 30. In AF patients in which a P2Y12 inhibitor is concomitantly used with OAC, we suggest the use of clopidogrel (Weak recommendation, low quality evidence). Remark: Newer agents (eg, ticagrelor) can be considered where bleeding risk is low. 