Question

A 69-year-old man with paroxysmal atrial fibrillation (AF), hypertension, and diabetes (CHA2DS2-VASc = 3), normal renal function, and no mechanical valve asks about stroke prevention. What is the most appropriate next step?

Accepted Answer

Start apixaban 5 mg orally twice daily

Answer

Begin aspirin 81 mg daily

Answer

No anticoagulation because AF is paroxysmal

Answer

Start warfarin with INR goal 1.5-2.0

Answer

Dual antiplatelet therapy with aspirin and clopidogrel

Practice question

A 69-year-old man with paroxysmal atrial fibrillation (AF), hypertension, and diabetes (CHA2DS2-VASc = 3), normal renal function, and no mechanical valve asks about stroke prevention. What is the most appropriate next step?