What antithrombotic options are available for patients with nonvalvular atrial fibrillation, a CHA2 -VASc score of 2, and acceptably low risk for hemorrhagic complications?
Oral anticoagulants are recommended for patients with nonvalvular atrial fibrillation, a CHA2-VASc score of 2, and acceptably low risk for hemorrhagic complications (Class I). Options include warfarin (INR, 2.0 to 3.0) (Level of Evidence A), dabigatran (Level of Evidence B), apixaban (Level of Evidence B), and rivaroxaban (Level of Evidence B). The selection of antithrombotic agent should be individualized on the basis of patient risk factors (particularly risk for intracranial hemorrhage), cost, tolerability, patient preference, potential for drug interactions, and other clinical characteristics, including time INR is in therapeutic range for patients taking warfarin.