1. A fib and Antithrombotic Therapy Cases Angie Pegram, PharmD, BCPS, CDE March 7, 2013

2. Case # 1 • AF is a 48 year old WF with new onset a fib. She was admitted for RVR and now is rate controlled with diltiazem. Current EKG shows a fib. She has no known past medical history and was taking no medications prior to hospitalization. • Does this patient need antithrombotic therapy for stroke prevention?

3. CHADS2 Score

4. CHA2DS2-VASc Score

5. Case # 2 • RW is a 77 year old AAM with diabetes, HTN and known a fib. He has refused warfarin in the past, but he was admitted for a TIA last night. He would like to know more about anticoagulation, as he is thinking he might change his mind about the warfarin now. • Does this patient need antithrombotic therapy for stroke prevention?

6. CHADS2 Score

7. CHA2DS2-VASc Score

8. Case # 3 • AF is a 68 year old WF with new onset a fib. She was admitted for RVR and now is rate controlled with diltiazem. Current EKG shows a fib. She has no known past medical history and was taking no medications prior to hospitalization. • Does this patient need antithrombotic therapy for stroke prevention?

9. CHADS2 Score

10. CHA2DS2-VASc Score