Patients with atrial fibrillation are at variable risks for developing a stroke. The risk is significantly increased among the elderly. Other risks factors include hypertension, diabetes, poor ventricular function, and a prior history of TIA or stroke. Among the elderly, it is generally recommended that those patients who are eligible for anticoagulation would benefit substantially from its use provided the INR is maintained between 2.0-3.5 and blood pressure is well controlled. In those patients that cannot be safely anticoagulated, aspirin at a dose of 325 mg is a viable alternative but is likely to offer substantially less protection than warfarin.
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