Anticoagulation for Patients with Atrial Fibrillation and One Risk Factor

Clinical Takeaway

: A South Korean trial suggests benefit.

Context

Whether patients with atrial fibrillation (AF) and intermediate risk for stroke (CHA₂DS₂-VASc score of 1 for men or 2 for women) would benefit from anticoagulation is unclear. Observational data have been mixed, and randomized trial data are sparse. To address this question, South Korean researchers randomized 1800 patients (mean age, 60) with AF and intermediate risk for stroke to a direct-acting oral anticoagulant (DOAC; apixaban or rivaroxaban) or to no anticoagulation.

Key Results

At 24 months, the primary end point (i.e., composite of stroke, systemic embolism, major bleeding, or cardiovascular-related death) had occurred in significantly fewer patients in the DOAC group than in the no-anticoagulation group (0.3% vs. 1.1%; number …

Reviewing Author

Mark S. Link, M.D.

Disclosures

Editorial BoardsCirculation; UpToDate