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[Comment] Can biomarkers balance stroke and bleeding risk?

Age and previous stroke, together with other clinical risk factors (often summarised in the CHA2DS2VASc score), identify patients with atrial fibrillation at high risk for stroke. Dose-adjusted warfarin prevents ischaemic strokes, prolongs life, and maintains autonomy in such patients.1,2 Hence, oral anticoagulation is currently recommended for all patients with atrial fibrillation with two of the CHA2DS2VASc risk factors, and should be considered in those with one of them.1,2 Although even reinitiation of anticoagulation after an intracerebral bleed seems to be associated with improved outcomes,3,4 bleeding is a major reason to stop anticoagulation, which still drives underuse of anticoagulation in patients with atrial fibrillation.

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