Question

A 63-year-old man with non-valvular atrial fibrillation, hypertension, diabetes, and prior stroke presents for anticoagulation management. His CHA2DS2-VASc score is 5. He has stage 3 chronic kidney disease with estimated GFR 40 mL/min/1.73 m². According to current guidelines, which anticoagulant strategy is preferred to reduce stroke risk?

Accepted Answer

Direct oral anticoagulant such as apixaban adjusted for renal function

Answer

Aspirin 81 mg daily alone

Answer

Dual antiplatelet therapy with aspirin and clopidogrel

Answer

No therapy because his bleeding risk is high

Answer

Low-dose warfarin with target INR 1.5 to 2.0

Practice question