For patients who are unsuitable for or choose not to take an oral anticoagulant (for reasons other than con- cerns about major bleeding), we suggest com- bination therapy with aspirin and clopidogrel rather than aspirin (75 mg to 325 mg once daily) (Grade 2B). Remarks: Patients who place an exceptionally high value on stroke reduction and a low value on avoiding bleeding and the burden associated with anticoagu- lant therapy are likely to choose oral anticoagulation rather than antiplatelet therapy. Other factors that may in uence the choice among antithrombotic ther- apies are a consideration of bleeding risk and the presence of additional risk factors for stroke, includ- ing age 65 to 74 years and female gender, which have been more consistently validated, and vascular disease, which has been less well validated (see sec- tion 2.1.12). The presence of multiple additional non-CHADS2 risk factors for stroke may favor oral anticoagulation therapy. 2.1.10. For patients with AF, including those with paroxysmal AF, who are at high risk of stroke (eg, CHADS2 score 2), we recommend oral anticoagulation rather than no therapy (Grade 1A), aspirin (75 mg to 325 mg once daily) (Grade 1B), or combination therapy with aspirin and clopidogrel (Grade 1B). For patients who are unsuitable for or choose not to take an oral anticoagulant (for reasons other than concerns Revision accepted August 31, 2011. 