A 68-year-old man with paroxysmal atrial fibrillation, hypertension, and type 2 diabetes presents to establish care. He has no valvular disease, no rh...

Question

A 68-year-old man with paroxysmal atrial fibrillation, hypertension, and type 2 diabetes presents to establish care. He has no valvular disease, no rheumatic mitral stenosis, and normal renal function. His CHA2DS2-VASc score is 3 (age 65-74, hypertension, diabetes). What is the most appropriate strategy to reduce his stroke risk?

Accepted Answer

Initiate a direct oral anticoagulant (e.g., apixaban)

Answer

Start warfarin with bridging low-molecular-weight heparin

Answer

Begin aspirin 81 mg daily

Answer

No antithrombotic therapy is needed

Answer

Percutaneous left atrial appendage occlusion now

us-usmle-step-2 MCQ (SBA): Atrial Fibrillation