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Stroke medication secondary prevention — DGM MCQ

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HardStroke and rehabilitationStroke medication secondary preventionDGM

An 81-year-old man had an ischaemic stroke two months ago and is found to have atrial fibrillation. He is taking antiplatelet therapy but no anticoagulant. He has no recent bleeding and renal function is acceptable. Current medicines include clopidogrel, atorvastatin and amlodipine. Which medication should be reviewed?

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Reveal the answer and explanation

Correct answer: A — Need for anticoagulation

Atrial fibrillation after ischaemic stroke usually requires anticoagulation assessment because antiplatelet therapy alone is inadequate for cardioembolic prevention. Atorvastatin and amlodipine help vascular risk but do not replace anticoagulation; paracetamol and colecalciferol are unrelated. Stroke mechanism should guide secondary prevention.

Reference: NICE stroke guidance; NICE AF guidance