The impact on renal function after long-term use of anticoagulants in atrial fibrillation patients

Autor: Wei-Chieh Lee, Pai-Wei Lee, Po-Jui Wu, Yen-Nan Fang, Huang-Chung Chen, Yu-Sheng Lin, Hsiu-Yu Fang, Shang-Hung Chang, Ping-Yen Liu, Mien-Cheng Chen
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Thrombosis Journal, Vol 19, Iss 1, Pp 1-11 (2021)
Druh dokumentu: article
ISSN: 1477-9560
DOI: 10.1186/s12959-021-00351-1
Popis: Abstract Objective Long-term oral anticoagulant should be considered or recommended in patients with atrial fibrillation (AF) and CHA2DS2VASc score ≥ 1 for stroke prevention. Warfarin and different direct oral anticoagulants (DOACs) are metabolized differently by the kidney. The impact on renal function after long-term use of anticoagulants in the patients with AF remains unclear. This study aimed to compare DOACs and warfarin’s impact on the decline in renal function from a large cohort with AF. Methods This study included patients with nonvalvular AF from 2000 to 2018, mainly through the medical history (ICD code) of the Chang Gung Research Database. Baseline estimated glomerular filtration rate (eGFR), follow-up eGFR and the change in eGFR between 2-year eGFR and baseline eGFR were compared between different DOACs and warfarin after propensity score matching. The primary study endpoint was acute kidney injury (AKI). Results 3657 patients were enrolled in this study and the mean observation time was 3.3 ± 0.9 years. During the observation period, there was a significantly higher incidence of AKI during follow-up in the warfarin group than in the different DOAC groups before and after propensity score matching (before: warfarin vs. DOAC: 9.2% vs. 5.2%, p
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