Key result
DOACs improve stroke prevention with less bleeding versus warfarin in AF and CKD.
Why the study?
Do direct thrombin inhibitors and factor Xa inhibitors improve stroke prevention and reduce bleeding compared to warfarin in patients with atrial fibrillation and chronic kidney disease?
Do direct thrombin inhibitors and factor Xa inhibitors improve stroke prevention and reduce bleeding compared to warfarin in patients with atrial fibrillation and chronic kidney disease?
Novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) offer improved stroke prevention and reduced bleeding risk compared to warfarin in the high-risk population of patients with atrial fibrillation and chronic kidney disease.
Atrial fibrillation (AF) is about three-times more prevalent in patients with chronic kidney disease and the prevalence of AF increases with the degree of renal impairment. Clinical studies have shown increased risk of stroke, bleeding and death in patients with chronic kidney disease and AF. Despite, this increased risk, anticoagulation is underutilized due to increased bleeding risk in this population. Recently direct thrombin inhibitors and factor Xa inhibitors have been shown to be more efficacious in stroke prevention with reduced bleeding than warfarin. As the usage of these novel anticoagulants increases it is important to understand the data available in regard to these high risk patients.
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Turagam et al. (2013) conducted a review in Atrial fibrillation and chronic kidney disease. Novel anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) vs. Warfarin was evaluated. Direct thrombin inhibitors and factor Xa inhibitors have been shown to be more efficacious in stroke prevention with reduced bleeding than warfarin in patients with AF and chronic kidney disease.
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