Warfarin Better Than Aspirin plus Clopidogrel in Atrial Fibrillation

Oral anticoagulants such as warfarin are far more effective than aspirin for preventing stroke in patients with atrial fibrillation, but such anticoagulants are difficult to manage and can cause major bleeding complications. Might clopidogrel plus aspirin offer a safer alternative to oral anticoagulation in patients with atrial fibrillation? In an international study, sponsored by manufacturers of clopidogrel and warfarin, researchers randomized more than 6700 patients with atrial fibrillation and at least one other stroke risk factor to receive either clopidogrel (75 mg once daily) plus aspirin (75–100 mg recommended) or oral anticoagulation with the locally preferred vitamin K antagonist (titrated to an INR between 2.0 and 3.0). About 12%…