Oral anticoagulants benefit patients with atrial fibrillation at intermediate stroke risk
· News-MedicalSINGLE-AF was an open-label trial conducted at 18 centers in South Korea. A total of 1,803 individuals with AF and an intermediate risk of stroke (defined as a CHA2DS2-VASc score of 1 in men or 2 in women) were randomized (1:1) to receive DOAC therapy (apixaban 5 mg twice daily or rivaroxaban 20 mg once daily) or to no anticoagulation.
At 24 months, a 69% reduction in the primary endpoint - a composite of stroke, systemic embolism, major bleeding or cardiovascular death - was observed with DOACs vs. no anticoagulation (0.5% and 1.5%, respectively; p=0.028; hazard ratio 0.31; 95% confidence interval 0.10 to 0.94). The difference between the groups appeared to be driven by a lower incidence of ischaemic stroke with DOAC therapy (0.1%) vs. no anticoagulant therapy (1.1%). There was no difference in major bleeding with DOAC therapy (0.3%) and without (0.5%).
Professor Joung concluded, "We now have evidence from a randomized trial that patients with AF at intermediate stroke risk benefit from DOAC therapy, without an increase in major bleeding. Data from the SINGLE-AF trial may be used to inform future guideline recommendations and reimbursement policies."
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