Figure 2.

European Society of Cardiology (ESC) guideline recommendations for the prevention of stroke in patients with AF.¹² Antiplatelet therapy with ASA plus clopidogrel, or—less effectively—ASA only, should be considered in patients who refuse any oral anticoagulant or cannot tolerate anticoagulants for reasons unrelated to bleeding. If there are contraindications to oral anticoagulation or antiplatelet therapy, left atrial appendage occlusion, closure, or excision may be considered. CHA₂DS₂-VASc score: turquoise, 0; yellow, 1; red, ≥2. Line: solid, best option; dashed, alternative option. ^aIncludes rheumatic valvular disease and prosthetic valves. AF, atrial fibrillation; ASA, acetylsalicylic acid; CHA₂DS₂-VASc, ESC-recommended stroke risk score [Congestive heart failure/left ventricular dysfunction, Hypertension, Age ≥75 years (doubled) Diabetes, Stroke (doubled), Vascular disease, Age 65–74 years, Sex category (female)]; HAS-BLED, [ESC-recommended bleeding risk score, defined as Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly (e.g. age >65 years, frailty, etc.), Drugs/alcohol use]; NOAC, non-vitamin K antagonist oral anticoagulant; VKA, vitamin K antagonist. From Camm et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. European Heart Journal Nov 2012, 33(21) 2719–2747. Reproduced with permission of Oxford University Press (UK) © European Society of Cardiology, www.escardio.org/guidelines