After the rst 12 months, antithrombotic therapy is suggested as for patients with AF and stable coronary artery disease (see section 3.1). Remarks: Patients who place an exceptionally high value on stroke reduction and a low value on avoid- ing bleeding and the burden associated with antico- agulant therapy are likely to choose adjusted-dose VKA therapy plus single antiplatelet therapy rather than dual antiplatelet therapy. Other factors that may in uence this choice are a consideration of bleed- ing risk and the presence of additional non-CHADS2 risk factors for stroke (see section 2.1.12). bleeding and the burden associated with anticoag- ulant therapy are likely to choose triple therapy rather than dual antiplatelet therapy. Other fac- tors that may in uence this choice are a consider- ation of bleeding risk and the presence of additional non-CHADS2 risk factors for stroke (see section 2.1.12). 3.3 Patients With AF and ACS Who Do Not Undergo Intracoronary Stent Placement Dual antiplatelet therapy (eg, with aspirin and clopidogrel) rather than aspirin alone is recommended during the rst 12 months after an ACS, regardless of whether patients also receive an intracoronary stent (Vandvik et al108). Many patients with AF (eg, CHADS2 score of 1) will choose VKA therapy (eg, warfarin) to prevent future stroke (section 2.1). Therefore, treatment options in patients with AF and recent ACS may include warfarin plus dual antiplatelet therapy (ie, triple therapy), dual antiplatelet therapy, or warfarin plus single antiplatelet therapy. In this section, we speci cally address patients with AF and ACS who do not undergo placement of an intracoro- nary stent. 