Nonvalvular Atrial Fibrillation in Medicine / Internal Medicine — 72yo Woman | Cardiology | SMLE Q#18744

SMLE Question #18744

Medicine / Internal Medicine Cardiology

Objective: OBJ-IM-CARD-ANTICOAG-AF

Last updated: March 2026
A 72-year-old woman with nonvalvular atrial fibrillation presents for long-term stroke prevention. She has hypertension and type 2 diabetes. Two years ago, she had a nonvariceal upper gastrointestinal bleed related to NSAID use and recovered fully. She has no prior stroke or intracranial bleeding. She has no mechanical heart valve and no moderate-to-severe mitral stenosis. Renal function is normal, and long-term oral anticoagulation is planned. Which oral anticoagulant is most appropriate?

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