For a patient with NVAF and a CHA2DS2-VASc score of 3, which anticoagulant regimen is most appropriate?

In patients with non-valvular atrial fibrillation (NVAF) and a CHA2DS2-VASc score of 3, the selection of an anticoagulant must be guided by both efficacy in reducing the risk of stroke and safety with respect to bleeding potential.

Apixaban, with a dosing of 5 mg twice daily, is a direct oral anticoagulant (DOAC) that has demonstrated effective stroke prevention in patients with NVAF. The prescribed dosage makes it particularly suitable for patients with a CHA2DS2-VASc score of 3 due to its well-documented benefits in this population. Studies have shown that apixaban significantly reduces the risk of stroke and is associated with a lower rate of major bleeding compared to other anticoagulants, making it a preferred choice for patients at moderate to high risk of thromboembolic events.

The use of this regimen is further supported by its favorable pharmacokinetic properties, which include fewer drug-drug interactions than some other options and no requirement for routine monitoring of anticoagulation levels. Additionally, apixaban has been shown to have renal safety, and its dosing can be adjusted in certain populations, enhancing its utility in clinical practice.

Other options, while effective treatments