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Prophylactic warfarin is recommended for patients with atrial fibrillation who are at high risk for ischemic stroke. However, warfarin use is associated with hemorrhagic complications. These investigators conducted an observational cohort study to assess the net clinical benefit of warfarin therapy in patients with AF. Of 13,559 adults with a diagnosis of AF between July 1, 1996, and December 31, 1997 (median age, 73), 53% were taking warfarin, and 20% had no additional major risk factors for ischemic stroke. More warfarin recipients than nonrecipients had other risk factors for stroke, and fewer warfarin recipients had a history of bleeding. On average, the INR of warfarin recipients was in the therapeutic range during 65.4% of a median fo…