Question

A 68-year-old man with hypertension and diabetes presents with new atrial fibrillation (CHA₂DS₂‑VASc = 3). Creatinine clearance 70 mL/min. What is the best next step to reduce stroke risk?

Accepted Answer

Start apixaban at therapeutic dose

Answer

Begin dual antiplatelet therapy with aspirin and clopidogrel

Answer

No therapy because paroxysmal AF confers low risk

Answer

Warfarin only if CHADS₂ ≥2

Answer

Left atrial appendage occlusion immediately

Practice question

A 68-year-old man with hypertension and diabetes presents with new atrial fibrillation (CHA₂DS₂‑VASc = 3). Creatinine clearance 70 mL/min. What is the best next step to reduce stroke risk?