Anticoagulants are thought to be more effective than antiplatelet agents (mainly aspirin) at reducing stroke, as well as systemic embolism risk in patients with AF.9,10 However, hemorrhage and bleeding have been linked to the use of both.5 Therefore, achieving an optimal balance between the risk of stroke and bleeding is crucial for the individual management of AF. Data generated by trials comparing a placebo with an anticoagulant or an antiplatelet agent may not address this issue. To remedy this problem, several randomized trials have compared the effects of treatment with an anticoagulant with those of an antiplatelet therapy; however, recent meta-analyses of these trials are lacking. The importance of this topic warrants an update to the existing literature; therefore, the objective of the present study was to conduct a meta-analysis of randomized trials comparing the safety and efficacy of anticoagulant and antiplatelet therapies for patients with AF. We focused our analysis on those studies comparing adjusted-dose anticoagu- lants with antiplatelet therapy.