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Atrial fibrillation stroke prevention — RACP Adult Medicine MCQ

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HardCardiologyAtrial fibrillation stroke preventionRACP Adult Medicine

A 67-year-old woman with hypertension and type 2 diabetes is found to have persistent atrial fibrillation during admission for pneumonia. Echocardiography shows normal valves and preserved left ventricular systolic function. She asks what most determines her future stroke risk. What is the most important prognostic factor?

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Correct answer: D — Age and comorbidity-based thromboembolic risk profile

Stroke risk in atrial fibrillation is driven primarily by age and comorbidities such as hypertension, diabetes, heart failure and prior stroke. A transient trigger does not remove the need to assess thromboembolic risk. Normal systolic function, aspirin exposure and symptom burden are less important than validated clinical risk factors.

Reference: NHFA/CSANZ atrial fibrillation guidance; AMH