Benz AP, Hijazi Z, Lindbäck J, et al. - Given that a better performance of the novel ABC (Age, Biomarkers, Clinical History) scores than that of conventional risk scores for stroke, major bleeding and death has been seen in patients with atrial fibrillation (AF) undergoing oral anticoagulation, there is a requirement to validate the ABC-AF scores in patients not taking oral anticoagulation in order to refine their utility. To apply the earlier constructed ABC-AF scores in patients with AF taking aspirin (n = 3,195) or aspirin and clopidogrel (n = 1,110) in two large clinical trials, experts recorded plasma concentrations of the ABC biomarkers (N-terminal pro-B-type natriuretic peptide, cardiac troponin-T and growth-differentiation factor-15). In both cohorts, a c-index of 0.70 was offered by the ABC-AF-stroke score. The ABC-AF-bleeding score was identified to have a c-index of 0.76 in the aspirin only cohort and 0.73 overall. Superiority to current guidelines-recommended risk scores was demonstrated by both scores. In this study, better discrimination than conventional risk scores was offered by the biomarker-based ABC-AF scores and these were recalibrated for accurate risk determination in patients not taking oral anticoagulation. Improved decision support, with respect to treatment of an individual patient with AF, can now be offered by these.