A 76-year-old woman has been newly diagnosed with atrial fibrillation. She has hypertension, diabetes, and had a TIA 6 months ago. Her CHA₂DS₂-VASc sc...

Question

A 76-year-old woman has been newly diagnosed with atrial fibrillation. She has hypertension, diabetes, and had a TIA 6 months ago. Her CHA₂DS₂-VASc score is 5. She also has a history of peptic ulcer bleeding 3 years ago (now healed, no H. pylori). Her HAS-BLED score is 3. Should she be anticoagulated?

Accepted Answer

Yes - the stroke risk with CHA₂DS₂-VASc 5 outweighs the bleeding risk, but she should also receive gastroprotection with a PPI

Answer

No - her bleeding risk outweighs the stroke risk

Answer

Yes - start dual antiplatelet therapy instead of anticoagulation

Answer

No - her previous TIA means she has already had the event and anticoagulation will not help

Answer

Yes - but only if she has a repeat OGD first

uk-dgm MCQ (SBA): Anticoagulation Decision with High Stroke and Bleeding Risk