However, it is reasonable to assume that data for coronary artery disease would be generally applicable to PAD or carotid disease. One post hoc from the ROCKET-AF trial reported that the ef cacy of rivaroxaban when compared with warfarin for the prevention of stroke or systemic embolism was similar in patients with PAD (HR, 1.19; 95% CI, 0.63-2.22) and without PAD (HR, there was a higher risk of major bleeding or non- major, clinically relevant bleeding with rivaroxaban when compared with warfarin in AF patients with PAD (HR, 1.40; 95% CI, 1.06-1.86) compared with those without PAD (HR, 1.03; 95% CI, 0.95-1.11; interaction P .037). Recommendations 20. In AF patients presenting with an ACS and/or undergoing PCI/stenting, we recommend assessment of stroke risk using the CHA2DS2-VASc score (Strong recommendation, moderate quality evidence). Remark: All such patients are not low risk and should be considered for concomitant OAC. 21. In AF patients presenting with an ACS and/or undergoing PCI/stenting, we suggest attention to modi able bleeding risk factors at every patient contact, and assessment of bleeding risk using the HAS-BLED score (Weak recommendation, low quality evidence). Remark: Where bleeding risk is high (HAS-BLED $ 3), there should be more regular review and follow-up. 22. In AF patients requiring OAC undergoing elective PCI/stenting, where bleeding risk is low (HAS-BLED 0-2) relative to risk for recurrent ACS and/or stent thrombosis, we suggest triple therapy for 1 month, followed by dual therapy with OAC plus single antiplatelet (preferably clopidogrel) until 12 months, following which OAC monotherapy can be used (Weak recommendation, low quality evidence). 23. 