Doacs reduce cardiovascular events in lower-risk atrial fibrillation
The SINGLE-AF randomized trial enrolled 1,803 atrial fibrillation patients with a single CHA2DS2-VASc risk factor and found direct oral anticoagulants reduced the 24-month composite cardiovascular event rate to 0.5% versus 1.5% without anticoagulation (hazard ratio 0.31, 95% CI 0.10–0.94). Annual stroke incidence was 0.15% with DOACs versus 0.6% without, while major bleeding rates were similar (0.3% vs 0.5%) and no cardiovascular deaths occurred. The trial was open-label, had very few events, and was done in South Korea, so authors urge cautious interpretation and call for further study and consideration by guideline bodies.
DOACs lowered composite events in single-risk Afib over 24 months.
Context
A randomized trial tested DOAC therapy in Afib patients with one stroke risk factor. The trial found fewer composite cardiovascular events with DOACs. Next steps could include larger or more diverse trials and guideline reviews.
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