Question

A 78-year-old man with permanent atrial fibrillation, hypertension, type 2 diabetes and a previous transient ischaemic attack (TIA) attends review. He is in rate-controlled AF on Bisoprolol and Aspirin 75 mg. His CHA2DS2-VASc score is 6. What is the most appropriate antithrombotic strategy?

Accepted Answer

Start a direct-acting oral anticoagulant such as Apixaban and stop Aspirin (unless there is another indication)

Answer

No antithrombotic therapy is required

Answer

Continue Aspirin alone

Answer

Start dual antiplatelet therapy with Aspirin and Clopidogrel

Answer

Start low-dose Warfarin (INR 1.5–2.0)

Practice question

A 78-year-old man with permanent atrial fibrillation, hypertension, type 2 diabetes and a previous transient ischaemic attack (TIA) attends review. He is in rate-controlled AF on Bisoprolol and Aspirin 75 mg. His CHA2DS2-VASc score is 6. What is the most appropriate antithrombotic strategy?