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NEUROSAE 2018 ANNUAL MEETING EDITION (VOLUME 10, ISSUE 3)
QUESTION 37 OF 100
A 78-year-old man presents with a history of paroxysmal atrial fibrillation and a recent nondisabling ischemic stroke. Which of the following factors is not routinely considered in the decision to initiate anticoagulant therapy in a patient with a history of paroxysmal atrial fibrillation?
B. diabetes mellitus
C. advanced Age
D. congestive heart failure
E. cigarette smoking **
** = Your answer
A history of cigarette smoking is not a risk factor commonly considered in the assessment of stroke risk in patients with a history of paroxysmal atrial fibrillation. Although these patients are at higher risk for ischemic stroke and transient ischemic attack (TIA), risk varies depending on patient risk factors. The CHADS2 score has been validated to stratify the risk of stroke in this population. History of stroke or TIA, congestive heart failure, diabetes mellitus, hypertension, and patient age are among the risk factors considered in CHADS2 scoring system.
* Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001 Jun 13;285(22):2864-2870.