image: Among patients with non-valvular AF treated in routine clinical practice, compared with VKA, DOAC use was associated with a lower risk of CKD progression, AKI, and major bleeding, but a similar risk of the composite of stroke/systemic embolism and death. (Trevisan et al, AJKD 2022) view more
Credit: Visual Abstract for "Cardiorenal Outcomes Among Patients With Atrial Fibrillation Treated With Oral Anticoagulants" by Trevisan et al (AJKD 2022)
Swedish cohort study shows 13% (95% CI, 2-22%) lower risk of kidney function decline or kidney failure and 12% (95% CI, 3-20%) lower risk of acute kidney injury with use of direct oral anticoagulants vs. vitamin K antagonists for non-valvular atrial fibrillation.
The relative safety of anticoagulation with direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA) remains inconclusive, particularly with regards to kidney outcomes. In a cohort of patients with non-valvular atrial fibrillation from Sweden, researchers observed that compared with VKA, DOAC initiation was associated with a lower risk of the composite of kidney failure and sustained 30% eGFR decline, as well as a lower risk of AKI occurrence. In agreement with trial evidence, DOAC vs VKA treatment was associated with a lower risk of major bleeding, but a similar risk of the composite of stroke, systemic embolism, or death. Collectively, these findings recently published in the American Journal of Kidney Diseases (AJKD) add to emerging evidence on the safety and effectiveness of DOAC administered for atrial fibrillation.
TITLE: Cardiorenal Outcomes Among Patients With Atrial Fibrillation Treated With Oral Anticoagulants
AUTHORS: Marco Trevisan, PhD, Paul Hjemdahl, MD, Catherine M. Clase, MB BChir MSc, Ype de Jong, MD, Marie Evans, MD, Rino Bellocco, PhD, Edouard L. Fu, MD, and Juan Jesus Carrero, Pharm PhD
DOI: https://doi.org/10.1053/j.ajkd.2022.07.017
Journal
American Journal of Kidney Diseases
Article Publication Date
5-Oct-2022