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ModerateCardiologyAtrial Fibrillationus-usmle-step-2us-usmle-step-3us-abimus-abfm

A 72-year-old man with paroxysmal atrial fibrillation, hypertension, and type 2 diabetes has a CHA₂DS₂‑VASc score of 3. His creatinine clearance is 65 mL/min and his time in therapeutic range on warfarin is 45%. What is the most appropriate strategy for stroke prevention?

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