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AF-Concomitant Antiplatelet Use — EECC MCQ

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ModerateCardiologyAF-Concomitant Antiplatelet UseEECC

A 74-year-old woman with atrial fibrillation and a prior stroke is asking about taking aspirin concurrently for primary prevention of coronary artery disease. She has no recent acute coronary syndrome or percutaneous coronary intervention. What is recommended?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Stop aspirin unless there is a clear secondary prevention indication

Dual therapy, consisting of an anticoagulant and aspirin, increases the risk of bleeding without providing additional benefit in patients with atrial fibrillation who do not have a clear secondary prevention indication. Warfarin is not superior to direct oral anticoagulants, and adding antiplatelets to anticoagulation in this scenario is generally considered harmful.

Reference: NICE NG196: Atrial fibrillation—diagnosis and management: https://www.nice.org.uk/guidance/ng196/chapter/recommendations