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. Bushnell et al Guidelines for Prevention of Stroke in Women 1571 mL/min), lower weight (<50 kg), or advanced liver disease (impaired baseline clotting function) (Class I; Level of Evidence A). Depression and Psychosocial Stress In addition to being a well-recognized sequela of stroke,397 depression is associated with increased risk of stroke inci- dence among both women and men. In the INTERSTROKE case-control study of stroke participants from 22 countries,92 investigators found that self-reported depression (defined as feeling sad, blue, or depressed for 2 consecutive weeks dur- ing the past 12 months) was associated with a 35% increased odds of stroke (95% CI, 1.10 1.66) after adjustment for age, sex, and region. In addition, psychosocial stress (defined with a combined measure of general stress at home and in the workplace and categorized by permanent or several periods of stress versus no or some periods of stress in the past year) was associated with a 30% increased odds of stroke (95% CI, 1.06 1.60) in the adjusted model. Although the multivariable models were adjusted for sex, there were no sex-specific anal- yses performed in this cohort. 