Two randomized trials assessed the potential role of the combination of clopidogrel (75 mg daily) plus aspirin (75 100 mg daily) for prevent- ing stroke in patients with AF. The AF Clopidogrel Trial With Irbesartan for Prevention of Vascular Events (ACTIVE) investigators compared this combination antiplatelet regi- men with adjusted-dose warfarin (target INR, 2 to 3) in AF patients with 1 additional risk factor for stroke in ACTIVE W and found a reduction in stroke risk with warfarin compared with the dual antiplatelet regimen (RR reduction, 40%; 95% CI, 18 56; P=0.001) and no significant difference in risk of ACTIVE A compared the combination of clopidogrel and aspirin with aspirin alone in AF patients who were deemed unsuitable for warfarin anticoagulation and who had at least 1 additional risk factor for stroke ( 25% Table 4. Odds ratios of intracranial hemorrhage relative to warfarin with an INR of 2.0 to 3.0 Drug Dose(s) OR (95% CI) Reference twice daily Dabigatran 110 to 150 mg twice daily CI indicates confidence interval; INR, international normalized ratio; and OR, odds ratio. Adapted with permission from Chatterjee et al.411 Copyright 2013, American Medical Association. All rights reserved. Authorization for this adaptation has been obtained both from the owner of the copyright in the original work and from the owner of copyright in the translation or adaptation. were deemed unsuitable because of concern for warfarin- Dual antiplatelet therapy resulted in a significant reduction in all strokes (including parenchy- mal ICH) over treatment with aspirin alone (RR reduction, 28%; 95% CI, 17 38; P=0.0002) but also resulted in a sig- nificant increase in major bleeding (RR increase, 57%; 95% CI, 29 92; P<0.001). 