August 28, 2026New England Journal of Medicine
Anticoagulation for Atrial Fibrillation with a Single Risk Factor for Stroke
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“Patients who receive DOACs or vitamin K antagonists have an increased risk of bleeding, with 60 to 100% more major bleeds than patients who receive no anticoagulation or antiplatelet therapy, respectively. Therefore, the decision to initiate or continue anticoagulation must weigh the risk of treatment-induced bleeding against the benefit of stroke prevention with oral anticoagulation.”
“Taken within the context of the results of the SINGLE-AF trial, the use of anticoagulation in patients with atrial fibrillation and a single risk factor for stroke may be encouraged. In patients with a low atrial fibrillation burden, no therapy may be preferred.”
DBDr. Boyoung Joung
“SINGLE-AF is thus the first randomized trial to support a clinical benefit to DOAC therapy in these patients.”
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Paulus Kirchhof (2026) studied this question.