Question

A 72-year-old man with paroxysmal atrial fibrillation (AF) has hypertension and diabetes (CHA₂DS₂-VASc = 3). No mechanical valve or moderate-severe mitral stenosis. Which is the best next step to reduce stroke risk?

Accepted Answer

Begin a direct oral anticoagulant

Answer

Begin aspirin 81 mg daily

Answer

No antithrombotic therapy needed

Answer

Begin warfarin targeting INR 1.5-2.0

Answer

Dual antiplatelet therapy with aspirin and clopidogrel

Practice question

A 72-year-old man with paroxysmal atrial fibrillation (AF) has hypertension and diabetes (CHA₂DS₂-VASc = 3). No mechanical valve or moderate-severe mitral stenosis. Which is the best next step to reduce stroke risk?