Question

A 69-year-old man with nonvalvular atrial fibrillation, hypertension, and type 2 diabetes has a CHA2DS2-VASc score of 3. Creatinine clearance is 72 mL/min, no history of bleeding, and no mechanical valve. What is the most appropriate next step to reduce stroke risk?

Accepted Answer

Start apixaban 5 mg twice daily

Answer

Start warfarin with INR target 2.5

Answer

No anticoagulation; begin aspirin 81 mg daily

Answer

Implant left atrial appendage occlusion device now

Answer

Delay therapy until a transesophageal echocardiogram is performed

Practice question

A 69-year-old man with nonvalvular atrial fibrillation, hypertension, and type 2 diabetes has a CHA2DS2-VASc score of 3. Creatinine clearance is 72 mL/min, no history of bleeding, and no mechanical valve. What is the most appropriate next step to reduce stroke risk?