Lee HJ, et al. - Researchers performed this study to test the safety as well as the efficacy of non-vitamin K antagonist oral anticoagulants (NOACs) for primary prevention of stroke. Two thousand three hundred ninety-seven patients were identified using the Korean Health Insurance Review and Assessment Service database with hypertrophic cardiomyopathy and nonvalvular atrial fibrillation who were on oral anticoagulation from 2013 to 2016 with no history of ischemic stroke, intracranial hemorrhage (ICH), or gastrointestinal bleeding (992 on warfarin and 1,405 on NOACs). The incidence rates of ischemic stroke, ICH, gastrointestinal bleeding, death, and composite outcome were all significantly lower in the NOAC group vs the warfarin group over a mean follow-up of 1.6 years. Findings suggested a correlation between NOACs and significantly lower risks of ischemic stroke, ICH, gastrointestinal bleeding, death, and the composite outcome vs warfarin. In real-world Asian patients with hypertrophic cardiomyopathy with atrial fibrillation, NOACs exhibited greater efficacy and safety in the primary prevention of stroke vs warfarin.