Anticoagulation in AF With One Stroke Risk Factor | SINGLE-AF | ESC 2026
Anticoagulation in AF With One Stroke Risk Factor | SINGLE-AF | ESC 2026
Source:NEJM،
Medscape , Sep 15, 2026. | ESC 2026
• 1,803 intermediate-risk AF patients: CHA₂DS₂-VASc 1 in men or 2 in women —: DOAC vs no anticoagulation; follow-up ~2 years.
• Primary outcome: 0.5% vs 1.5%; ischemic stroke 3 vs 10; major bleeding 3 vs 4.
• Relative benefit looks substantial, but absolute benefit is small: only ~1 event prevented per 100 patients treated for 2 years (NNT ≈100).
• With only 3 vs 10 strokes, the result is statistically fragile—a change of only 1–2 events could alter significance.
• Take-home: DOAC can further reduce an already-low stroke risk, but the absolute gain is small ; in AF with only one stroke risk factor, this supports individualized shared decision-making rather than automatic anticoagulation.
https://www.nejm.org/doi/full/10.1056/NEJMoa2607978