Therapy with vitamin K antagonists in patients with atrial fibrillation and chronic kidney disease

2020 ◽  
Vol 13 (4) ◽  
pp. 355
Author(s):  
Z.K. Salpagarova ◽  
M.I. Chashkina ◽  
A.A. Bykova ◽  
Z.A. Alimova ◽  
A.Yu. Gubina ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Vitamin K Antagonists

scholarly journals Non-vitamin K antagonist oral anticoagulants vs. vitamin-K antagonists in patients with atrial fibrillation and chronic kidney disease: a nationwide cohort study

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Emma Kirstine Laugesen ◽  
Laila Staerk ◽  
Nicholas Carlson ◽  
Anne-Lise Kamper ◽  
Jonas Bjerring Olesen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Major Bleeding ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
All Cause Mortality ◽  
Comparable Population

Abstract Background We aimed to compare effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin-K antagonists (VKA) in atrial fibrillation (AF) patients with chronic kidney disease (CKD) not receiving dialysis. Methods By using personal identification numbers, we cross-linked individual-level data from Danish administrative registries. We identified every citizen with a prior diagnosis of AF and CKD who initiated NOAC or VKA (2011–2017). An external analysis of 727 AF patients with CKD (no dialysis) was performed to demonstrate level of kidney function in a comparable population. Study outcomes included incidents of stroke/thromboembolisms (TEs), major bleedings, myocardial infarctions (MIs), and all-cause mortality. We used Cox proportional hazards models to determine associations between oral anticoagulant treatment and outcomes. Results Of 1560 patients included, 1008 (64.6%) initiated VKA and 552 (35.4%) initiated NOAC. In a comparable population we found that 95.3% of the patients had an estimated glomerular filtration rate (eGFR) < 59 mL/min. Patients treated with NOAC had a significantly decreased risk of major bleeding (hazard ratio (HR): 0.47, 95% confidence interval (CI): 0.26–0.84) compared to VKA. There was not found a significant association between type of anticoagulant and risk of stroke/TE (HR: 0.83, 95% CI: 0.39–1.78), MI (HR: 0.45, 95% CI: 0.18–1.11), or all-cause mortality (HR: 0.99, 95% CI: 0.77–1.26). Conclusion NOAC was associated with a lower risk of major bleeding in patients with AF and CKD compared to VKA. No difference was found in risk of stroke/TE, MI, and all-cause mortality.

OPTIMIZATION OF VITAMIN K ANTAGONISTS THERAPY IN PATIENTS WITH ATRIAL FIBRILLATION AND CHRONIC KIDNEY DISEASE

2018 ◽  
Vol 71 (11) ◽  
pp. A288
Author(s):  
Zukhra Salpagarova ◽  
Denis Andreev ◽  
Aleksandra Bykova ◽  
Maria Chashkina ◽  
Raisa Kosharnaya ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Vitamin K Antagonists

Abstract 13927: Advanced Age and Preferential Use of Vitamin K Antagonists in Severe Renal Impairment: First Results of the XARENO Registry in Patients With Non-valvular Atrial Fibrillation and Non-dialysis Dependent Advanced Chronic Kidney Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Reinhold Kreutz ◽  
Gilbert Deray ◽  
Juergen Floege ◽  
Marianne Gwechenberger ◽  
Andreas Luft ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Vitamin K ◽  
Severe Renal Impairment ◽  
Vitamin K Antagonists ◽  
Thromboembolic Events ◽  
Increased Risk ◽  
First Results

Introduction: Patients with chronic kidney disease (CKD) and non-valvular atrial fibrillation (NVAF) are at increased risk for both ischemic stroke and hemorrhage. In addition, treatment with vitamin K antagonists (VKA) has been associated with worsening of renal function compared to direct oral anticoagulants (DOACs). XARENO (Factor XA -inhibition in RENal patients with non-valvular atrial fibrillation Observational registry) is an ongoing prospective, non-interventional, observational study conducted in Europe. XARENO evaluates the effectiveness of rivaroxaban in preserving renal function and preventing thromboembolic events as compared to VKA in NVAF patients with CKD in clinical practice. Methods: XARENO included male and female NVAF patients ≥18 years old with an estimated glomerular filtration rate (eGFR) between 15 and 49 mL/min per 1.73 m 2 and an indication for anticoagulation. Enrolment took place from April 2016 until January 2020. Patients treated with either rivaroxaban or VKA were included, while patients in whom physicians were withholding any anticoagulation could be also enrolled. Minimal planned follow-up is one year. Primary observational outcomes include efficacy and safety outcomes (progression of CKD, stroke, other thromboembolic events, major cardiovascular events, major bleeding, and all-cause mortality). First results on outcomes in the full cohort are expected in 2021. Results: In this analysis of a first set of 1485 patients (56.1% males), 731 and 666 patients received rivaroxaban and VKA, while 88 patients did not receive any anticoagulation. Mean age at baseline was 77.3 years (67.5% older than 75 years) with a mean eGFR of 38.9 mL/min per 1.73 m 2 . Overall 74.7% of patients had eGFR values below 45 mL/min per 1.73 m 2 and 28.0% below 30 mL/min per 1.73 m 2 . In the latter group, use of a VKA was about twofold more frequent compared to rivaroxaban. Conclusions: This first analysis of XARENO patients reveals the very high age of NVAF patients with concomitant non-dialysis dependent advanced CKD and a preferential use of VKA in stage 4 CKD. XARENO aims to provide important information on the real-world effectiveness and safety of rivaroxaban compared with VKA for this vulnerable patient group.

scholarly journals Efficacy and Safety of Vitamin K-Antagonists (VKA) for Atrial Fibrillation in Non-Dialysis Dependent Chronic Kidney Disease

PLoS ONE ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. e94420 ◽  
Author(s):  
Judith Kooiman ◽  
Nienke van Rein ◽  
Bas Spaans ◽  
Koen A. J. van Beers ◽  
Jonna R. Bank ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Efficacy And Safety

Chronic kidney disease and anticoagulation: from vitamin K antagonists and heparins to direct oral anticoagulant agents

2017 ◽  
Vol 12 (8) ◽  
pp. 1101-1108 ◽  
Author(s):  
Savino Sciascia ◽  
Massimo Radin ◽  
Karen Schreiber ◽  
Roberta Fenoglio ◽  
Simone Baldovino ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Vitamin K Antagonists ◽  
Direct Oral Anticoagulant ◽  
Anticoagulant Agents

Non-Vitamin K Oral Anticoagulant Drugs for Stroke Prevention in Patients with Atrial Fibrillation and Chronic Kidney Disease

2016 ◽  
Vol 23 (19) ◽  
pp. 2055-2069 ◽  
Author(s):  
Tatjana S. Potpara ◽  
Vera Jokic ◽  
Nikolaos Dagres ◽  
Torben B. Larsen ◽  
Deirdre A. Lane ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Stroke Prevention ◽  
Oral Anticoagulant ◽  
Anticoagulant Drugs

Atrial fibrillation and chronic kidney disease

ESC CardioMed ◽  
2018 ◽  
pp. 2237-2240
Author(s):  
Ken Okumura ◽  
Hirofumi Tomita
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Oral Anticoagulants ◽  
Cardiovascular Complications ◽  
Vitamin K Antagonist ◽  
Bleeding Complications ◽  
The Common

Atrial fibrillation (AF) is one of the common cardiovascular complications in patients with chronic kidney disease (CKD), and enhances synergistically the risks of stroke, systemic thromboembolism, and bleeding complications, resulting in increased mortality. One major concern in the treatment strategy for patients with AF and CKD has been a lack of robust evidence that improves quality of life and prognosis. Although a paradigm shift from warfarin to non-vitamin K antagonist oral anticoagulants has occurred in stroke prevention in AF, the role and indication of non-vitamin K antagonist oral anticoagulants remain to be established in patients with advanced CKD. Considering the fact that the prevalence of CKD in the general population increases with age, elderly people suffering from both CKD and AF will be increasingly frequent in the highly aged societies.

Sign in / Sign up

Export Citation Format

Share Document