Apixaban in Patients with Atrial Fibrillation and Severe Renal Dysfunction: Findings from a National Registry.
Isr Med Assoc J
; 23(6): 353-358, 2021 Jun.
Article
em En
| MEDLINE
| ID: mdl-34155848
ABSTRACT
BACKGROUND:
Real-world information regarding the use of direct oral anticoagulants therapy and the outcome in patients with renal dysfunction is limited.OBJECTIVES:
To evaluate the clinical characteristics and outcomes of patients with atrial fibrillation (AF) and severe renal dysfunction who are treated with apixaban.METHODS:
A sub-analysis was conducted within a multicenter prospective cohort study. The study included consecutive eligible apixaban- or warfarin-treated patients with non-valvular AF and renal impairment (estimated glomerular filtration rate [eGFR] modification of diet in renal disease [MDRD] < 60 ml/min/BSA) were registered. All patients were prospectively followed for clinical events and over a mean period of 1 year. Our sub-analysis included the patients with 15 < eGFR MDRD < 30 ml/min/BSA. The primary outcomes at 1 year were recorded. They included mortality, stroke or systemic embolism, major bleeding, and myocardial infarction as well as their composite occurrence.RESULTS:
The sub-analysis included 155 warfarin-treated patients and 97 apixaban-treated ones. All had 15 < eGFR MDRD < 30 ml/min/BSA. When comparing outcomes for propensity matched groups (n=76 per group) of patients treated by reduced dose apixaban or warfarin, the rates of the 1-year composite endpoint as well as mortality alone were higher among the warfarin group (30 [39.5%] vs. 14 [18.4%], P = 0.007 and 28 [36.8%] vs.12 [15.8%], P = 0.006), respectively. There was no significant difference in the rates of stroke, systemic embolism, or major bleeding.CONCLUSIONS:
Apixaban might be a reasonable alternative to warfarin in patients with severe renal impairment.
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Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Varfarina
/
Acidente Vascular Cerebral
/
Insuficiência Renal
/
Hemorragia
/
Infarto do Miocárdio
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article