Anticoagulation at intermediate AF stroke risk gets its first trial

The edition in brief

SINGLE-AF randomised 1,803 Korean patients with atrial fibrillation at intermediate stroke risk — a CHA2DS2-VASc score of 1 in men or 2 in women — to a direct oral anticoagulant or none. Over 24 months the composite of stroke, embolism, major bleeding or cardiovascular death occurred in 0.5% against 1.5%, with no visible excess of major bleeding, but on only 17 events in total. A Chinese trial in 584 patients with septic shock undergoing source-control surgery found that adding low-dose dobutamine to norepinephrine during the operation was associated with fewer cases of new or worsening acute kidney injury within a week, 22.8% against 34.7%, at the cost of more tachycardia. TRIUMPH-2 found that retatrutide, a triple GIP, GLP-1 and glucagon agonist, cut body weight by 12% to 19% at 80 weeks in people with obesity and type 2 diabetes, against 5% on placebo, with more gastrointestinal effects, hypotension and dysaesthesia. A Swedish case-control study of over 600,000 births found quadrivalent HPV vaccination before pregnancy associated with slightly lower odds of preterm birth. ROAM found adjuvant radiotherapy after complete resection of atypical meningioma halved recurrence. The pearl covers absolute and relative risk.