SINGLE-AF: DOAC Therapy vs. No Anticoagulation in AFib Patients at Intermediate Risk For Stroke - American College of Cardiology

The SINGLE-AF trial found that DOAC therapy reduced a composite outcome of stroke, systemic embolism, major bleeding, or cardiovascular death at 24 months versus no anticoagulation in atrial fibrillation (AFib) patients at intermediate stroke risk. Presented at ESC Congress 2026 and published simultaneously in the New England Journal of Medicine, the study randomized 1,803 patients at multiple centers in South Korea to apixaban 5 mg twice daily or rivaroxaban 20 mg once daily, or to no anticoagulation. Mean age was 60 and nearly 24% were women. At 24 months, events occurred in 0.5% with DOACs vs 1.5% without (hazard ratio 0.31, p=0.028).