A 74-year-old woman with persistent atrial fibrillation has hypertension and diabetes. She has no mechanical valve, no moderate-to-severe mitral

Question

A 74-year-old woman with persistent atrial fibrillation has hypertension and diabetes. She has no mechanical valve, no moderate-to-severe mitral stenosis, no major bleeding history, and creatinine clearance is 62 mL/min. Which of the following is the most appropriate next step in management?

Accepted Answer

Start oral anticoagulation with a direct oral anticoagulant

Answer

Inferior vena cava filter placement

Answer

Aspirin therapy as stroke prevention

Answer

Clopidogrel monotherapy for atrial fibrillation

Answer

No antithrombotic therapy because rhythm is stable

Atrial fibrillation anticoagulation — USMLE Step 3 MCQ

A 74-year-old woman with persistent atrial fibrillation has hypertension and diabetes. She has no mechanical valve, no moderate-to-severe mitral stenosis, no major bleeding history, and creatinine clearance is 62 mL/min. Which of the following is the most appropriate next step in management?