Atrial fibrillation, moderate chronic kidney disease, and stroke prevention: new anticoagulants, new hope
Key result
In patients with atrial fibrillation and moderate renal impairment, rivaroxaban showed consistent efficacy for stroke prevention compared with warfarin (HR 0.84) without excess bleeding.
Why the study?
Does rivaroxaban reduce stroke and systemic embolic events in patients with non-valvular atrial fibrillation and moderate chronic kidney disease compared to warfarin?
Population
2950 subjects with non-valvular atrial fibrillation, moderate renal impairment, and additional stroke risk…
Comparison
Rivaroxaban 15 mg daily vs Standard warfarin therapy aiming at an…
Design
Editorial
Authors
Discussion
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Member takes
Implication
In patients with non-valvular atrial fibrillation and moderate chronic kidney disease, rivaroxaban provides consistent stroke prevention benefits without an increased risk of bleeding compared to warfarin.
Structured PICO
Does rivaroxaban reduce stroke and systemic embolic events in patients with non-valvular atrial fibrillation and moderate chronic kidney disease compared to warfarin?
P
Population
2,950 patients with non-valvular atrial fibrillation and moderate renal impairment (eGFR 30-49 mL/min) from the ROCKET-AF trial.
I
Intervention
Rivaroxaban 15 mg daily
C
Comparator
Standard warfarin therapy aiming at an international normalized ratio (INR) of 2.0-3.0
O
Outcome
Stroke or systemic embolic eventshard clinical
Main Result
Hazard Ratio: 0.84
In patients with non-valvular atrial fibrillation and moderate chronic kidney disease, rivaroxaban provides consistent stroke prevention benefits without an increased risk of bleeding compared to warfarin.
Limitations
- Paucity of data in AF patients with more severe degrees of CKD (eGFR <30 mL/min) and in those on renal replacement therapy.
- Paucity of data in AF patients with more severe degrees of CKD (eGFR <30 mL/min)
- Paucity of data in patients on renal replacement therapy
Cite This Study
Hohnloser et al. (2011) conducted an editorial in Non-valvular atrial fibrillation and moderate renal impairment (n=2,950). Rivaroxaban vs. Warfarin (target INR 2.0-3.0) was evaluated on Stroke or systemic embolic events (HR 0.84). In patients with atrial fibrillation and moderate renal impairment, rivaroxaban showed consistent efficacy for stroke prevention compared with warfarin (HR 0.84) without excess bleeding.