Key result
In patients with atrial fibrillation and advanced chronic kidney disease (Stage IV or V), oral anticoagulant use was associated with a significantly increased risk of major bleeding (HR 2.32) compared to no oral anticoagulation.
Why the study?
Does oral anticoagulant and antiarrhythmic drug use affect outcomes differently in atrial fibrillation patients with versus without chronic kidney disease?
Observational (n=9,019)
Yes
Does oral anticoagulant and antiarrhythmic drug use affect outcomes differently in atrial fibrillation patients with versus without chronic kidney disease?
Hazard Ratio: 2.32 (95% CI 1.12–4.81)
p-value: p=0.0239
In patients with atrial fibrillation, advanced CKD is associated with lower use of rhythm control and OACs, and OAC use in this population may carry higher risks of both bleeding and stroke.
No takes yet. Share an insight, caveat, or question.
Suggests caution with OAC in AF and advanced CKD; leaves optimal strategy open pending randomized trials.
Washam et al. (2018) conducted an observational in Atrial Fibrillation with Chronic Kidney Disease (n=9,019). Oral anticoagulant (OAC) use vs. No OAC use was evaluated on First ISTH major bleeding event (in Stage IV or V CKD) (HR 2.32, 95% CI 1.12-4.81, p=0.0239). In patients with atrial fibrillation and advanced chronic kidney disease (Stage IV or V), oral anticoagulant use was associated with a significantly increased risk of major bleeding (HR 2.32) compared to no oral anticoagulation.
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