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Canadian Pharmacist Qualifying Exam Practice · Question

A 70-year-old male presents with new onset atrial fibrillation. His CHADS2-VASc score is 3. His past medical history includes hypertension and type 2 diabetes. He has no history of stroke or TIA. Which of the following anticoagulants is most appropriate for stroke prevention?

For non-valvular atrial fibrillation with a CHADS2-VASc score of 2 or more, oral anticoagulation is recommended. NOACs (like dabigatran) are generally preferred

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Question: A 70-year-old male presents with new onset atrial fibrillation. His CHADS2-VASc score is 3. His past medical history includes hypertension and type 2 diabetes. He has no history of stroke or TIA. Which of the following anticoagulants is most appropriate for stroke prevention?

Answer options:

  • Aspirin 81 mg daily.
  • Warfarin with a target INR of 2.0-3.0. ✅ Dabigatran 150 mg twice daily.
  • Clopidogrel 75 mg daily.

Correct answer: Dabigatran 150 mg twice daily.

Explanation: For non-valvular atrial fibrillation with a CHADS2-VASc score of 2 or more, oral anticoagulation is recommended. NOACs (like dabigatran) are generally preferred over warfarin due to a more favourable safety profile and ease of use, unless there are specific contraindications. Aspirin and clopidogrel are not recommended for stroke prevention in AF.

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