Low-dose warfarin plus aspirin is not optimal in high-risk AF

Cumulative event rate of patients with AF at high risk for thromboembolism in the SPAF III trial. High risk was defined as the presence of at least 1 of the following: previous thromboembolism, female older than 75 years of age, heart failure or severe left ventricular systolic dysfunction, and systolic pressure >160 mmHg. There was a much lower incidence of events with standard adjusted-dose warfarin therapy (INR 2 to 3) compared with treatment with aspirin and low-dose warfarin (INR 1.2 to 1.5; p<0.0001).