Question

A 74-year-old man with non-valvular atrial fibrillation, hypertension and type 2 diabetes presents for review. He has no prior stroke or bleeding. His CHA2DS2-VASc score is 4. Renal function is normal. What is the most appropriate long-term stroke prevention strategy?

Accepted Answer

A direct oral anticoagulant such as apixaban at full stroke-prevention dose

Answer

No antithrombotic therapy because he is in rate-controlled atrial fibrillation

Answer

Aspirin 100 mg daily alone

Answer

Warfarin with target INR 2.0-3.0

Answer

Dual antiplatelet therapy with aspirin and clopidogrel

Practice question

A 74-year-old man with non-valvular atrial fibrillation, hypertension and type 2 diabetes presents for review. He has no prior stroke or bleeding. His CHA2DS2-VASc score is 4. Renal function is normal. What is the most appropriate long-term stroke prevention strategy?