Question

A 78-year-old woman with chronic atrial fibrillation and hypertension is admitted after a fall at home with a Colles fracture. She has had three falls in the past year. Her CHA2DS2-VASc score is 4 and HAS-BLED score is 2. She is currently on warfarin with a stable INR of 2.4. What is the most appropriate advice regarding anticoagulation?

Accepted Answer

Continue warfarin at current dose with falls risk assessment and mitigation

Answer

Stop warfarin permanently because recurrent falls are a contraindication to anticoagulation

Answer

Switch from warfarin to aspirin alone to reduce bleeding risk

Answer

Reduce the warfarin dose to target an INR of 1.5-2.0

Answer

Change to dual antiplatelet therapy with aspirin and clopidogrel instead of warfarin

Practice question