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10. Perera V, Bajorek BV, Matthews S et al. The impact of frailty on the utilization of antithrombotic therapy in older patients with atrial fibrillation. Age Ageing 2008; doi:10.1093/ageing/afn293. 11. Connolly SJ, Pogue J, Eikelboom J et al. ACTIVE W Investigators. Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range. Circulation 2008; 118: 2029–37. 12. Jones M, McEwan P, Morgan CL et al. Evaluation of the pattern of treatment, level of anticoagulation control, and outcome of treatment with warfarin in patients with non-valvar atrial fibrillation: a record linkage study in a large British population. Heart 2005; 91: 472–7. 13. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007; 146: 857–67 14. Stroke Prevention in Atrial Fibrillation study. Final results. Circulation 1991; 84: 933–5. 15. Antithrombotic Trialists’ Collaboration. Collaborative metaanalysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324: 71–86. 16. Lip GYH. Does atrial fibrillation confer a hypercoagulable state? Lancet 1995; 346: 1313–4. 17. Belch J, MacCuish A, Campbell I et al. Prevention of Progression of Arterial Disease and Diabetes Study Group; Diabetes Registry Group; Royal College of Physicians, Edinburgh. The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008; 337: a1840 18. Flaker GC, Gruber M, Connolly SJ et al. SPORTIF Investigators. Risks and benefits of combining aspirin with anticoagulant therapy in patients with atrial fibrillation: an exploratory analysis of stroke prevention using an oral thrombin inhibitor in atrial fibrillation (SPORTIF) trials. Am Heart J 2006; 152: 967–73. 19. Hughes M, Lip GY. Guideline Development Group, National Clinical Guideline for Management of Atrial Fibrillation in Primary and Secondary Care, National Institute for Health and Clinical Excellence. Stroke and thromboembolism in atrial fibrillation: a systematic review of stroke risk factors, risk stratification schema and cost effectiveness data. Thromb Haemost 2008; 99: 295–304. 20. Mant JW. Pro: ‘Warfarin should be the drug of choice for thromboprophylaxis in elderly patients with atrial fibrillation’. Why warfarin should really be the drug of choice for stroke prevention in elderly patients with atrial fibrillation. Thromb Haemost 2008; 100: 14–5. 21. Hughes M, Lip GY. Guideline Development Group for the NICE national clinical guideline for management of atrial fibrillation in primary and secondary care. Risk factors for anticoagulation-related bleeding complications in patients with atrial fibrillation: a systematic review. Q J Med 2007; 100: 599– 607.

Commencing antiplatelet therapy in older people after an acute ischaemic stroke