SINGLE-AF study shows 69% reduction in clinical events for atrial fibrillation patients

The SINGLE-AF study, a multicenter randomized clinical trial involving 1,803 patients across 18 medical institutions in South Korea, has demonstrated that direct oral anticoagulants (DOAC) significantly reduce the risk of major clinical events in patients with moderate stroke risk due to atrial fibrillation.

The study compared a DOAC treatment group (902 patients) against a group not using anticoagulants (901 patients) over a 24-month period. Results showed the cumulative incidence of the primary endpoint—a composite of stroke, systemic embolism, major bleeding, and cardiovascular death—was 0.5% in the DOAC group compared to 1.5% in the non-treatment group. This represents a 69% reduction in risk.

Notably, while the stroke rate was lower in the DOAC group (0.3% vs. 1.1%), there was no significant difference in major bleeding rates between the two groups, suggesting the preventive benefits can be achieved without an increased bleeding burden. The findings were featured in the Hot Line session at the ESC Congress 2026 and published in the New England Journal of Medicine (NEJM).