A 72-year-old man with paroxysmal atrial fibrillation, hypertension, and type 2 diabetes has a CHA₂DS₂‑VASc score of 3. His creatinine clearance is 65...

Question

A 72-year-old man with paroxysmal atrial fibrillation, hypertension, and type 2 diabetes has a CHA₂DS₂‑VASc score of 3. His creatinine clearance is 65 mL/min and his time in therapeutic range on warfarin is 45%. What is the most appropriate strategy for stroke prevention?

Accepted Answer

Apixaban 5 mg twice daily

Answer

Continue warfarin with higher INR goal (3.0-3.5)

Answer

Aspirin 81 mg daily alone

Answer

Discontinue anticoagulation

Answer

Therapeutic enoxaparin indefinitely

us-usmle-step-2 MCQ (SBA): Atrial Fibrillation

A 72-year-old man with paroxysmal atrial fibrillation, hypertension, and type 2 diabetes has a CHA₂DS₂‑VASc score of 3. His creatinine clearance is 65 mL/min and his time in therapeutic range on warfarin is 45%. What is the most appropriate strategy for stroke prevention?