(Section 4.1. in the 2014 AF Guideline) Recommendation-Specific Supportive Text (New or Modified) 1. New data are available for edoxaban. Edoxaban (30 or 60 mg once daily) was studied in a large ran- domized prospective AF trial; it was found to be noninferior to warfarin with regard to the preven- tion of stroke or systemic embolization and was associated with significantly lower rates of bleed- ing and death from cardiovascular causes.S4.1.1-11 Treatment of patients with AF with edoxaban, either 30 mg or 60 mg, should be based on assessment of the risks of stroke and bleeding. In ENGAGE-TIMI 48 (Effective Anticoagulation With Recommendations for Selecting an Anticoagulant Regimen Balancing Risks and Benefits (Continued) COR LOE Recommendations Recommendations for Selecting an Anticoagulant Regimen Balancing Risks and Benefits (Continued) COR LOE Recommendations CLINICAL STATEMENTS AND GUIDELINES Factor Xa Next Generation in Atrial Fibrillation Thrombolysis in Myocardial Infarction 48), the rate of systemic embolism and stroke was 1.5% with warfarin, compared with 1.2% with 60 mg of edoxaban (hazard ratio [HR]: 0.79; 97.5% CI: with 30 mg of edoxaban (HR: 1.07; 97.5% CI: 0.87 1.31; p=0.005 for noninferiority). The rate of major bleeding was 3.4% with warfarin, ver- sus 2.8% with 60 mg of edoxaban (HR: 0.80; mg of edoxaban (HR: 0.47; 95% CI: 0.41 0.55; In the 2014 AF Guideline, the presence of a prior stroke, a prior transient isch- emic attack, or a CHA2 -VASc score of 2 or greater was an indication to consider oral antico- agulants. In the present focused update, we are adding precision to the CHA2 -VASc scoring system on the basis of new published informa- tion. The COR and LOE of warfarin, dabigatran, rivaroxaban, and apixaban are unchanged from the 2014 AF Guideline. comparing NOACs with warfarin. 