Adjusted-dose warfarin reduced ischemic stroke or systemic embolism by 76% (95% CI 42-90; P<0.001) compared with aspirin plus low-dose warfarin in atrial fibrillation patients with stage 3 CKD.
RCT (n=1,936)
randomized
Does adjusted-dose warfarin reduce ischemic stroke or systemic embolism in high-risk atrial fibrillation patients with stage 3 CKD?
Adjusted-dose warfarin is highly effective at reducing ischemic stroke and systemic embolism in high-risk atrial fibrillation patients with stage 3 CKD, without significantly increasing major hemorrhage.
Effect estimate: 76% reduction (95% CI 42-90)
p-value: p=<0.001
BACKGROUND AND OBJECTIVES: The efficacy of adjusted-dose warfarin for prevention of stroke in atrial fibrillation patients with stage 3 chronic kidney disease (CKD) is unknown. DESIGN, SETTING, PARTICIPANTS, P < 0.001) by adjusted-dose warfarin compared with aspirin/low-dose warfarin; there was no difference in major hemorrhage (5 patients versus 6 patients, respectively). CONCLUSIONS: Among atrial fibrillation patients participating in the Stroke Prevention in Atrial Fibrillation III trials, stage 3 CKD was associated with higher rates of ischemic stroke/systemic embolism. Adjusted-dose warfarin markedly reduced ischemic stroke/systemic embolism in high-risk atrial fibrillation patients with stage 3 CKD.
Hart et al. (Fri,) conducted a rct in Atrial fibrillation with stage 3 chronic kidney disease (n=1,936). Adjusted-dose warfarin vs. aspirin (325 mg) plus fixed, low-dose warfarin was evaluated on ischemic stroke or systemic embolism (76% reduction, 95% CI 42-90, p=<0.001). Adjusted-dose warfarin reduced ischemic stroke or systemic embolism by 76% (95% CI 42-90; P<0.001) compared with aspirin plus low-dose warfarin in atrial fibrillation patients with stage 3 CKD.
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