Question

A 72-year-old woman with permanent atrial fibrillation (CHA₂DS₂-VASc 4, HAS-BLED 2) asks about stroke prevention. She has eGFR 58 mL/min/1.73m² and no mechanical valves. What is the most appropriate first-line anticoagulation?

Accepted Answer

Apixaban at standard dose

Answer

Aspirin 75 mg daily

Answer

Warfarin with INR target 2.0-3.0

Answer

Dual antiplatelet therapy (aspirin + clopidogrel)

Answer

No anticoagulation; rate control only

Practice question

A 72-year-old woman with permanent atrial fibrillation (CHA₂DS₂-VASc 4, HAS-BLED 2) asks about stroke prevention. She has eGFR 58 mL/min/1.73m² and no mechanical valves. What is the most appropriate first-line anticoagulation?