In addition, none of the trials of new anticoagulants were powered to determine a sex difference in efficacy versus warfarin. AF: Recommendations 1. Risk stratification tools in AF that account for age- and sex-specific differences in the incidence of stroke are recommended (Class I; Level of Evidence A). 2. Considering the increased prevalence of AF with age and the higher risk of stroke in elderly women with AF, active screening (in particular of women >75 years of age) in primary care settings using pulse taking followed by an ECG as appropriate is recom- mended (Class I; Level of Evidence B). 3. Oral anticoagulation in women aged 65 years with AF alone (no other risk factors; women with -VASc=1) is not recom- mended (Class III; Level of Evidence B). Antiplatelet therapy is a reasonable therapeutic option for selected low-risk women (Class IIa; Level of Evidence B). 4. New oral anticoagulants are a useful alternative to warfarin for the prevention of stroke and systemic thromboembolism in women with paroxysmal or permanent AF and prespecified risk factors (accord- ing to CHA2 -VASc) who do not have a prosthetic heart valve or hemodynamically significant valve dis- ease, severe renal failure (creatinine clearance <15 Table 13. Primary and Secondary Outcomes Among Participants in the ARISTOTLE, RELY, and ROCKET AF Trials Stratified by Sex ARISTOTLE RELY ROCKET AF No. of Events (%/y) No. of Events (%/y) No. of Events (%/y) n Apixaban Warfarin n Dabigatran Dabigatran 150 mg Warfarin n Rivaroxaban Warfarin Primary outcome Major bleeding ARISTOTLE indicates Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation; RELY, Randomized Evaluation of Long-term Anticoagulant Therapy; and ROCKET AF, Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation. 