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Many patients with new-onset atrial fibrillation (AF) receive anticoagulation with warfarin, but many have coexisting vascular disease that requires platelet inhibition. Combinations of warfarin, aspirin, and clopidogrel often are used and even endorsed in some practice guidelines, but their safety and benefit are not fully characterized.
Danish investigators used national registries to identify 119,000 patients who survived first hospitalizations for AF. Nearly 83,000 were discharged on warfarin, aspirin, clopidogrel, or combinations thereof — most commonly with warfarin alone (42.9%), aspirin alone (40.0%), or warfarin plus aspirin (15.5%). In analyses adjusted for age, sex, comorbidity, and concomitant medical therapies, risk for fatal or…