Recent evidence for direct oral anticoagulants in chronic kidney disease

Ha, Jeffrey; Badve, Sunil V.; Jun, Min

doi:10.1097/mnh.0000000000000493

Cited by 5 publications

(7 citation statements)

References 42 publications

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“…Любой антикоагулянт может провоцировать кровотечения, источником которых наиболее часто является желудочно-кишечный тракт [27]. Пациенты с желудочно-кишечными кровотечениями при сопутствующей ХБП имеют худшие исходы, чем пациенты с нормальной функцией почек, что проявляется более высокой смертностью, чем в общей популяции (ОР 1,8, 95% доверительный интервал [ДИ] 1,7-1,9; р<0,001 в сравнении с ХБП) [28,29].…”

Section: шкалы риска инсульта и кровотеченийunclassified

“…Используя результаты ключевых РКИ, T.J. Ha и соавт. выполнили подгрупповой анализ среди пациентов, разделенных в зависимости от рКлКр (<50, 50-80 и >80 мл/мин) [27].…”

Section: эффективность и безопасность поак в сравнении с варфариномunclassified

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Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Renal Dysfunction

Кобалава

Shavarov

Vatsik-Gorodetskaya

2021

Racionalʹnaâ farmakoterapiâ v kardiologii

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Atrial fibrillation and renal dysfunction often coexist, each disorder may predispose to the other and contribute to worsening prognosis. Both atrial fibrillation and chronic kidney disease are associated with increased risk of stroke and thromboembolic complications. Oral anticoagulation for stroke prevention is therefore recommended in patients with atrial fibrillation and decreased renal function. Each direct oral anticoagulant has unique pharmacologic properties of which clinician should be aware to optimally manage patients. The doses of direct oral anticoagulants require adjustment for renal function. There is debate regarding which equation, the Chronic Kidney Disease Epidemiology (CKD-EPI) equation vs. the Cockcroft-Gault equation, should be used to estimate glomerular filtration rate in patients with atrial fibrillation treated with direct oral anticoagulants. Our review tries to find arguments for benefit of direct oral anticoagulants in patients with renal dysfunction.

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Section: шкалы риска инсульта и кровотеченийunclassified

Section: эффективность и безопасность поак в сравнении с варфариномunclassified

Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Renal Dysfunction

Кобалава

Shavarov

Vatsik-Gorodetskaya

2021

Racionalʹnaâ farmakoterapiâ v kardiologii

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“…However, the clinical evaluation of a DOAC treatment in patients with a CrCl of 15-29 mL/min is still limited. 8,9 The objective of this study was to evaluate the safety and efficacy of DOACs in patients with a severely impaired renal function as compared to those with a mildly or moderately impaired renal function.…”

Section: Introductionmentioning

confidence: 99%

“…Prior meta‐analyses of randomized and Phase III trials have well demonstrated that DOACs were at least as safe and effective as dose‐adjusted warfarin for the management of AF. However, the clinical evaluation of a DOAC treatment in patients with a CrCl of 15‐29 mL/min is still limited 8,9 . The objective of this study was to evaluate the safety and efficacy of DOACs in patients with a severely impaired renal function as compared to those with a mildly or moderately impaired renal function.…”

Section: Introductionmentioning

confidence: 99%

Relationship between the degree of renal dysfunction and the safety and efficacy outcomes in patients with atrial fibrillation receiving direct oral anticoagulants

Wada

Shinohara

Nakanishi

et al. 2021

Journal of Arrhythmia

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“…Summary of renal impairment dose adjustment recommendations and primary literature for commonly used direct oral anticoagulants for atrial fibrillation[30][31][32][33][34].…”

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confidence: 99%

Safety and Efficacy of Direct Oral Anticoagulants for Atrial Fibrillation in Patients with Renal Impairment

2020

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Direct oral anticoagulants (DOACs) are gaining popularity for patients with nonvalvular atrial fibrillation (AF) for stroke prevention. Less bleeding risk with comparable stroke prevention compared to warfarin was shown. DOACs have predictable anticoagulant effects, infrequent monitoring requirements and less drug-food interactions compared to warfarin. However, safety and efficacy data of DOACs in patients with chronic kidney disease (CKD) are limited. This is a retrospective study to evaluate thromboembolic and bleeding events in patients with AF (with/without CKD) in October 2010 and July 2017. A total of 495 patients were included and only 150 patients had CKD. Our study found that patients with renal impairment on a DOAC do not have a higher incidence of bleeding events. It showed significant increase in thromboembolic events in CKD patients with dabigatran compared to CKD patients with apixaban with odds ratio of 6.58 (95%CI 1.35-32.02, p = 0.02).

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Recent evidence for direct oral anticoagulants in chronic kidney disease

Cited by 5 publications

References 42 publications

Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Renal Dysfunction

Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Renal Dysfunction

Relationship between the degree of renal dysfunction and the safety and efficacy outcomes in patients with atrial fibrillation receiving direct oral anticoagulants

Safety and Efficacy of Direct Oral Anticoagulants for Atrial Fibrillation in Patients with Renal Impairment

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