Safety and effectiveness of rivaroxaban and warfarin in moderate-to-advanced CKD: real world data.
J Nephrol
; 31(5): 751-756, 2018 Oct.
Article
en En
| MEDLINE
| ID: mdl-29882198
ABSTRACT
BACKGROUND:
In recent years, novel anticoagulant drugs have been introduced in the clinical armamentarium and have progressively gained momentum. Although their use is increasing among CKD patients, some skepticism about their risk-benefit ratio still persists. We sought to investigate the safety and effectiveness of rivaroxaban in a cohort of moderate-to-advanced CKD patients.METHODS:
This observational, retrospective, longitudinal study involved 347 consecutive CKD stage 3b-4 (according to NKF-KDOQI guidelines) patients enrolled from 8 cardiac outpatient clinics between March 2015 and October 2017. All patients received anticoagulation (100 warfarin vs. 247 rivaroxaban) as part of their non-valvular atrial fibrillation management at the attending physician's discretion. Clinical effectiveness (defined as the occurrence of ischemic stroke, venous thromboembolism, or transient ischemic attack) and safety (intracranial hemorrhage, gastrointestinal or other bleeding) were assessed separately.RESULTS:
Over a mean follow-up period of 16 ± 0.3 months, 25 stroke episodes (15 hemorrhagic, and 10 ischemic) occurred in 24 warfarin treated patients vs. none in the rivaroxaban arm. There were 5 vs. 0 episodes of deep venous thrombosis and 8 vs. 2 major episodes of bleeding in the warfarin and rivaroxaban groups, respectively. In contrast, the proportion of minor episodes of bleeding was similar between groups.CONCLUSION:
Rivaroxaban seems a safe and effective therapeutic option in CKD stage 3b-4 patients. However, future randomized controlled trials are needed to definitively establish the role of rivaroxaban in CKD patients.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
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Warfarina
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Trastornos Cerebrovasculares
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Insuficiencia Renal Crónica
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Inhibidores del Factor Xa
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Rivaroxabán
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Anticoagulantes
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Guideline
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Observational_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
País como asunto:
Europa
Idioma:
En
Año:
2018
Tipo del documento:
Article