RESUMO
Background: AF is a global health concern, with systemic complications including renal dysfunction. This systematic review and meta-analysis compares the effects of rivaroxaban, a Factor Xa inhibitor, and vitamin K antagonists (VKAs) on renal outcomes in AF patients. Methods: The study protocol is registered in PROSPERO (ID: CRD42023462756). We systematically searched the PubMed, Embase and Cochrane Library databases from 1 January 2017 to 30 June 2023 for real-world studies comparing the effects of rivaroxaban and VKAs on renal outcomes in AF patients, including acute kidney injury, a .30% decrease in estimated glomerular filtration rate, doubling of serum creatinine and worsening renal function. Subgroup analyses targeted diabetes, pre-existing kidney disease, the elderly (age .65 years) and Asian populations. The risk of bias was assessed used the Robins-I tool. HRs and 95% CIs were synthesised through a random-effects model. Two sensitivity analyses were performed, using a fixed-effects model and excluding conference abstracts. Results: We identified 1,666 records. After screening, 14 studies comparing rivaroxaban and VKAs were included. Rivaroxaban exhibited superiority over VKAs in preventing: acute kidney injury (HR 0.68; 95% CI [0.61.0.77]; p<0.00001); a .30% decrease in estimated glomerular filtration rate (HR 0.71; 95% CI [0.60.0.84]; p<0.0001); doubling of serum creatinine (HR 0.50; 95% CI [0.36.0.70]; p<0.0001); and worsening renal function (HR 0.56; 95% CI [0.45.0.69]; p<0.00001). Subgroup and sensitivity analyses consistently confirmed rivaroxaban's favourable effects on renal outcomes in diabetes, pre-existing kidney disease, the elderly and Asian populations. Conclusion: Our findings support the preference of rivaroxaban over VKAs for renal outcomes in AF. The findings endorse rivaroxaban as the preferred anticoagulant to mitigate renal complications, offering clinicians valuable insights for tailored strategies.
RESUMO
BACKGROUND: Hypertension (HTN) significantly contributes to global disease burden, and its prevalence varies amongst different countries and regions. This work is aimed to characterize the hypertensive prevalence and identify risk factors for HTN among the residents in five locations (four communes and one town) of Moc Chau district (Son La province, Vietnam). METHODS: A cross-sectional study with a cross-sectional methodology was done in selected places from August 2018 to December 2018. We interviewed 197 participants aged equal to or more than 18 years old and measured their blood pressure (BP). Univariate and multivariate logistic regression were applied. RESULTS: The overall HTN prevalence of 30.0% was recorded. The differences of HTN prevalence rates were seen by several characters including age groups (p <0.001), accompanying disease (p <0.001) and alcohol drinking (p <0.05). Factors independently associated with hypertension were age (ORs: 3.1 [1.1-9.1]; 6.1 [1.7-22.3]), much salty consumption (OR: 2.6 [1.1-6.6]), alcohol use (OR: 3.1 [1.2-8.1]), HTN familial history (OR: 4.2 [1.3-13.3]) and at least one suffering disease (OR: 5.2 [2.1-12.7]). CONCLUSIONS: Thus, this study highlighted the high overall HTN prevalence in the Vietnam Northwestern region. Significant differences of HTN rate were observed among several characteristics such as age groups, accompanying disease and alcohol drinking. Age group, much salty consumption, alcohol use, hypertension familial history and at least one suffering disease were risk factors for HTN in study group.