Oral anticoagulants reduce stroke risk in intermediate-risk atrial fibrillation patients

A large-scale study has found that newer oral anticoagulants, known as direct oral anticoagulants (DOACs), can reduce serious health events in patients with atrial fibrillation (AF) who possess an intermediate stroke risk.

Results from the SINGLE-AF trial, presented at ESC Congress 2026 and published in the New England Journal of Medicine, involved 1,803 participants across 18 centers in South Korea. Led by Professor Boyoung Joung of Yonsei University, the randomized study compared the use of apixaban or rivaroxaban against no anticoagulant treatment. While high-risk patients are typically advised to take anticoagulants, the decision for intermediate-risk patients has historically been more difficult due to the balance between stroke prevention and the risk of dangerous bleeding.

Atrial fibrillation is a common heart rhythm disorder where the upper chambers of the heart beat irregularly, potentially allowing blood to pool and form clots. If these clots travel to the brain, they can cause ischaemic strokes. AF can be caused by aging, heart disease, genetics, or tissue changes such as inflammation and fibrosis.