A 58-year-old male with persistent atrial fibrillation has a CHA2DS2-VASc score of 3. What is the guideline-directed therapy for stroke prevention?
Answer and explanation
Correct answer: A. Direct oral anticoagulant (DOAC) such as apixaban or rivaroxaban
- Step 1: For non-valvular atrial fibrillation with a CHA2DS2-VASc score >= 2 in males, systemic anticoagulation is strongly indicated.
- Step 2: DOACs (apixaban, rivaroxaban, dabigatran, edoxaban) are preferred over warfarin due to equal or superior efficacy and lower risk of intracranial hemorrhage.
- Step 3: Antiplatelet agents (aspirin or clopidogrel) are ineffective for cardioembolic stroke prevention.
Answer
Direct oral anticoagulant (DOAC) such as apixaban or rivaroxaban.
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