|A.||Warfarin with heparin bridging with goal INR 2-3|
Apixaban 5 mg twice daily with enoxaparin bridge
Apixaban 5 mg twice daily
Enoxaparin 80 mg twice daily
• The use of oral anticoagulation (OAC) is currently strongly recommended as first-line therapy for the prevention of primary and secondary strokes in patients with atrial fibrillation.
• Patients with atrial fibrillation with moderate to high risk of thromboembolic events may benefit from long-term anticoagulation.
• Most studies have shown that using direct thrombin and factor Xa inhibitors, such as apixaban and rivaroxaban, may have less risk of intracranial hemorrhage than patients on warfarin.
• The risk versus benefit for assessment of initiating anticoagulation can be calculated by using validated calculations, such as CHA2DS2-VASc for stroke risk, and HAS-BLED for bleeding risk. The recommendation is to initiate OAC if the CHA2DS2-VASc stratification score is 2 or greater