Incidence of thromboembolic stroke and of major bleeding in patients with atrial fibrillation and chronic kidney disease treated with and without warfarin
Key result
Warfarin use in patients with CKD and AF significantly reduced thromboembolic stroke (9% vs 26%; OR 0.28, P<0.0001) with an insignificant increase in major bleeding.
Why the study?
Does warfarin reduce thromboembolic stroke in patients with atrial fibrillation and chronic kidney disease?
Population
399 unselected patients with chronic kidney disease and atrial fibrillation, including 93 receiving…
Comparison
Warfarin to maintain an international normalized… vs No warfarin treatment (N = 167)
Design
Cohort
Follow-up
31 months for warfarin group, 23 months for no warfarin…
Authors
Discussion
Loading...
Member takes
Implication
May support warfarin in CKD-AF; leaves open confirmation of net benefit by randomized trials.
Study Design
Type
Observational (n=399)
Structured PICO
Does warfarin reduce thromboembolic stroke in patients with atrial fibrillation and chronic kidney disease?
P
Population
399 unselected patients with chronic kidney disease (CKD) and atrial fibrillation (AF), including 93 (23%) receiving hemodialysis and 132 (33%) with an estimated glomerular filtration rate (GFR) of <15 mL/min/1.73 m2
I
Intervention
Warfarin to maintain an international normalized ratio (INR) between 2.0 and 3.0 (N = 232)
C
Comparator
No warfarin treatment (N = 167)
O
Outcome
Incidence of thromboembolic strokehard clinical
Main Result
Effect estimate: OR 0.28
Absolute Event Rate: 9% vs 26%
p-value: p=<0.0001
In patients with atrial fibrillation and chronic kidney disease, warfarin therapy targeted to an INR of 2.0-3.0 significantly reduces thromboembolic stroke without a significant increase in major bleeding.
Cite This Study
Wilbert S. Aronow (2009) conducted an observational in chronic kidney disease and atrial fibrillation (n=399). warfarin vs. without warfarin was evaluated on thromboembolic stroke (OR 0.28, p=<0.0001). Warfarin use in patients with CKD and AF significantly reduced thromboembolic stroke (9% vs 26%; OR 0.28, P<0.0001) with an insignificant increase in major bleeding.