Acute Kidney Injury in Asians With Atrial Fibrillation Treated With Dabigatran or Warfarin

BACKGROUND: Whether dabigatran is associated with a lower risk of acute kidney injury (AKI) in patients with nonvalvular atrial fibrillation (NVAF) remains unknown. OBJECTIVES: The authors compared the risk of AKI in Asians with NVAF who were prescribed dabigatran versus warfarin. METHODS: The authors analyzed patients enrolled in the Taiwan nationwide retrospective cohort study from June 1, 2012, to December 31, 2013. Dabigatran and warfarin were taken by 7,702 and 7,885 NVAF patients without a history of chronic kidney disease (CKD) and 2,256 and 2,089 NVAF patients with a history of CKD, respectively. A propensity-score weighted method was used to balance covariates across study groups. RESULTS: -VASc ≥4 or HAS-BLED ≥3 (risk score based on hypertension, abnormal renal and liver function, stroke, prior major bleeding, labile international normalized ratios, age 65 years or older, drugs or alcohol usage history) all had a lower risk of AKI than those taking warfarin. CONCLUSIONS: Among Asians with NVAF, dabigatran is associated with a lower risk of AKI than warfarin.