The increased risk of thromboembolic events rose in women The AHA provides recommendations based on CHADS2 . The great majority of patients being assessed at stroke pre- vention clinics have a CHADS2 score 2, the clinical situation with strong evidence in favor of anticoagulation for high-risk patients (Class I; Level of Evidence A).377 These data suggest that women, especially those aged 75 years, have a higher stroke risk, and most benefit from anticoagulation therapy. Younger women (<65 years old) with AF alone (no other risk factors) have a lower risk of stroke. No specific sex benefits were observed when rate versus rhythm control strategies Evidence From Randomized Clinical Trials of New Oral Anticoagulants Most recent randomized clinical trials of new oral antico- agulants showed better stroke risk reduction and lower risk of intracranial bleeding. The benefit in women was compa- rable to that in men391 393 (Table 13). The RELY (Randomized Evaluation of Long-term Anticoagulant Therapy) study ran- domly assigned 18113 patients (36.4% women) withAF and a risk of stroke (mean CHADS2 score 2.2) to receive fixed doses of dabigatran (110 or 150 mg twice daily) or adjusted-dose warfarin. The median follow-up period was 2.0 years. The pri- mary outcome was stroke or systemic embolism. ARISTOTLE (Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation) was a randomized, double- blind trial comparing apixaban (5 mg twice daily) versus warfarin (target international normalized ratio, 2.0 3.0) in 18201 patients with AF and at least 1 additional risk factor for stroke (mean CHADS2 score 2.1). Women constituted one third (35.3%) of participants. 