Renal function, attributes and coagulation treatment in atrial fibrillation (R-FACT Study): Retrospective, observational, longitudinal cohort study of renal function and antithrombotic treatment patterns in atrial fibrillation patients with documented eGF

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation (n=15900). Primary outcome: Distribution, changes in renal function, and antithrombotic treatment pattern.

Di Wu; George A. Mansoor; C. Kempf; Marie‐Sophie Schwalm; Ji‐Hyun Chin

doi:10.1111/ijcp.12379

February 6, 2014International Journal of Clinical Practice

Renal function, attributes and coagulation treatment in atrial fibrillation (R-FACT Study): Retrospective, observational, longitudinal cohort study of renal function and antithrombotic treatment patterns in atrial fibrillation patients with documented eGF

View Full Paper

Ask AI

Bookmark

Share

Key result

In German atrial fibrillation patients, moderate-to-severe renal dysfunction was prevalent (~38%), and 52.1% of those with severely decreased eGFR received no antithrombotic treatment.

Key Points

To evaluate the distribution and progression of renal dysfunction and describe antithrombotic treatment patterns among patients with atrial fibrillation managed in primary care.
Extracted longitudinal clinical data from the German Longitudinal Patient Database for 15,900 patients with atrial fibrillation, including 1,660 patients with baseline estimated glomerular filtration rate (eGFR) measurements.
Assessed stroke risk across renal function strata using the CHADS2 score and evaluated predictors of eGFR deterioration over 12 months using multivariate Cox proportional hazards regression.
Moderate-to-severe renal dysfunction was present in 38.7% of patients with baseline eGFR (3.4% severe, 9.7% moderately severe, and 25.6% moderate), and 55.0% experienced eGFR decline during follow-up.
High stroke risk (CHADS2 score ≥ 2) occurred in 92.9% of patients with severe renal impairment, yet 52.1% of severe and 23.7%–26.3% of moderate impairment groups received no antithrombotic therapy.
Older age, diabetes mellitus, dyslipidaemia, and prior myocardial infarction were identified as statistically significant independent predictors of renal function deterioration.

Study Design

Type

Cohort (n=15,900)

Multicenter

Yes

Structured PICO

P

Population

15,900 patients with atrial fibrillation (AF) managed by general practitioners in Germany, with a subcohort of 1,660 having eGFR available at baseline.

I

Intervention

Antithrombotic treatment

O

Outcome

Distribution and changes in renal function (eGFR) and antithrombotic treatment patterns

In real-world German practice, moderate-to-severe renal dysfunction is common in AF patients, and anticoagulation is significantly underutilized in this high-risk group.

Implication

Renal assessment should inform AF anticoagulation review; leaves open whether closing gaps improves outcomes in real-world cohorts.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Wu et al. (2014) conducted a cohort in Atrial fibrillation (n=15,900). In German atrial fibrillation patients, moderate-to-severe renal dysfunction was prevalent (~38%), and 52.1% of those with severely decreased eGFR received no antithrombotic treatment.

synapsesocial.com/papers/6a16022b7cdde9fcee12759f https://doi.org/10.1111/ijcp.12379