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Warfarin was found to be more effective than aspirin for preventing stroke in elderly atrial fibrillation patients with no increased risk of bleeding. A randomized controlled trial of over 900 elderly AF patients assigned to warfarin or aspirin found warfarin reduced the risk of fatal or disabling stroke by over 50% compared to aspirin, with a number needed to treat of 50. There was no significant difference in major bleeding risks between the two groups. The results provide strong evidence that warfarin is preferable to aspirin for stroke prevention in elderly AF patients despite concerns about increased bleeding risk.













