Real-world 2-year outcome of atrial fibrillation treatment with dabigatran, apixaban, and rivaroxaban in patients with and without chronic kidney disease

Patients with non-valvular atrial fibrillation (NVAF) and chronic kidney disease (CKD) are at increased risk of stroke and bleeding. Although direct oral anticoagulant (DOAC) trials excluded patients with severe CKD, a growing portion of CKD patients have been starting DOACs and limited data from re...

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Bibliographic Details
Published in:Internal and emergency medicine 2019-11, Vol.14 (8), p.1259-1270
Main Authors: Godino, Cosmo, Melillo, Francesco, Rubino, Francesca, Arrigoni, Luca, Cappelletti, Alberto, Mazzone, Patrizio, Mattiello, Paolo, Della Bella, Paolo, Colombo, Antonio, Salerno, Anna, Cera, Michela, Margonato, Alberto
Format: Article
Language:English
Subjects:
Administration, Oral
Aged
Anticoagulants
Atrial Fibrillation - drug therapy
Atrial Fibrillation - physiopathology
Bleeding
Cardiac arrhythmia
Clinical trials
Creatinine
Dabigatran - standards
Dabigatran - therapeutic use
Factor Xa Inhibitors - standards
Factor Xa Inhibitors - therapeutic use
Female
Fibrillation
Health risks
Hemorrhage
Humans
Im - Original
Internal Medicine
Ischemia
Italy
Kidney diseases
Kidneys
Male
Medicine
Medicine & Public Health
Middle Aged
Pyrazoles - standards
Pyrazoles - therapeutic use
Pyridones - standards
Pyridones - therapeutic use
Registries - statistics & numerical data
Renal Insufficiency, Chronic - complications
Rivaroxaban - standards
Rivaroxaban - therapeutic use
Statistics, Nonparametric
Thromboembolism
Treatment Outcome
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Summary:Patients with non-valvular atrial fibrillation (NVAF) and chronic kidney disease (CKD) are at increased risk of stroke and bleeding. Although direct oral anticoagulant (DOAC) trials excluded patients with severe CKD, a growing portion of CKD patients have been starting DOACs and limited data from real-world outcome in this high-risk setting are available. The INSigHT registry included 632 consecutive NVAF patients that started apixaban (256 patients, 41%), dabigatran (245, 39%) and rivaroxaban (131, 20%) between 2012 and 2015. Based on creatinine clearance, two sub-cohorts were defined: (1) non-CKD group (CrCl 60–89 mL/min, 413 patients) and (2) CKD group (15–59 ml/min, 219). Compared to non-CKD patients, those with CKD, were at higher ischemic (CHA 2 DS 2 -VASc 4.5 vs 2.9, p  
ISSN:1828-0447
1970-9366
DOI:10.1007/s11739-019-02100-9