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Amir Askarinejad: SINGLE-AF at ESC 2026 – Important New Data for Anticoagulation in Intermediate-Risk AF
Amir Askarinejad/LinkedIn
Aug 29, 2026, 10:45

Amir Askarinejad: SINGLE-AF at ESC 2026 – Important New Data for Anticoagulation in Intermediate-Risk AF

Amir Askarinejad, Research Assistant at University of Liverpool, shared a post on LinkedIn:

“SINGLE-AF at ESC 2026: Important new data for anticoagulation in intermediate-risk AF

One of the most interesting trials from ESC 2026 addressing a very practical clinical question:

Should patients with atrial fibrillation and only one non-sex stroke risk factor receive oral anticoagulation?

PICO

  • Population: 1,803 patients with AF at intermediate stroke risk
  • Intervention: DOAC therapy
  • Comparator: No oral anticoagulation
  • Primary outcome: Composite of stroke, systemic embolism, major bleeding, or cardiovascular death at 2 years

Primary endpoint

  • DOAC: 0.5%
  • No OAC: 1.5%
  • HR 0.31 (95% CI 0.10–0.94)

Ischaemic stroke/systemic embolism

  • DOAC: 0.1%
  • No OAC: 1.1%
  • HR 0.10 (95% CI 0.01–0.77)

Major or clinically relevant non-major bleeding

  • DOAC: 2.7%
  • No OAC: 2.0%
  • HR 1.42 (95% CI 0.76–2.63)

Take-home message:

In patients with AF at intermediate stroke risk, DOAC therapy reduced net adverse clinical events at 2 years, with a particularly notable reduction in ischaemic thromboembolic events.

At the same time, the very low absolute event rates, small number of events, open-label design, and limited generalisability should be kept in mind.

A fascinating trial that may further inform the ongoing debate around anticoagulation in patients with a single non-sex CHA2DS2-VASc risk factor.”

Amir Askarinejad

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