Question

A 70-year-old with paroxysmal AF and prior GI bleed 5 years ago now has CHA₂DS₂‑VASc 4 and HAS‑BLED 2. He asks about anticoagulation choice. Which is preferred?

Accepted Answer

Apixaban over warfarin for lower bleeding risk with similar stroke reduction

Answer

Warfarin because prior GI bleed is a contraindication to DOACs

Answer

No anticoagulation due to prior bleed

Answer

Dual antiplatelet therapy instead of anticoagulation

Answer

Low-dose rivaroxaban 2.5 mg bid plus aspirin

Practice question

A 70-year-old with paroxysmal AF and prior GI bleed 5 years ago now has CHA₂DS₂‑VASc 4 and HAS‑BLED 2. He asks about anticoagulation choice. Which is preferred?