Lane, PhD; Mark H. Eckman, MD; Margaret C. Fang, MD, MPH; Elaine M. Hylek, MD, MPH; Sam Schulman, MD, PhD; Alan S. Go, MD; Michael Hughes, PhD; Frederick A. Spencer, MD; Warren J. Manning, MD; Jonathan L. Halperin, MD; and Gregory Y. H. Lip, MD e532S Antithrombotic Therapy for Atrial Fibrillation oral anticoagulation (Grade 2B) or combination therapy with aspirin and clopidogrel (Grade 2B). Remarks: Patients who place an exceptionally high value on stroke reduction and a low value on avoiding bleeding and the burden associated with antithrom- botic therapy are likely to choose antithrombotic therapy rather than no antithrombotic therapy. Other factors that may in uence the choices above are a consideration of patient-speci c bleeding risk and the presence of additional risk factors for stroke, including age 65 to 74 years and female gender, which have been more consistently validated, and vascular disease, which has been less well validated (see section 2.1.12). The presence of multiple non- CHADS2 risk factors for stroke may favor oral anti- coagulation therapy. 2.1.9. For patients with AF, including those with paroxysmal AF, who are at intermediate risk of stroke (eg, CHADS2 score 1), we recommend oral anticoagulation rather than no therapy (Grade 1B). We suggest oral anticoagulation rather than aspirin (75 mg to 325 mg once daily) (Grade 2B) or combination therapy with aspirin and clopidogrel (Grade 2B). For patients who are unsuitable for or choose not to take an oral anticoagulant (for reasons other than con- cerns about major bleeding), we suggest com- bination therapy with aspirin and clopidogrel rather than aspirin (75 mg to 325 mg once daily) (Grade 2B). 