Arrhythmias & electrophysiology
Different renal function estimation formulas for adverse outcomes in patients with atrial fibrillation receiving direct oral anticoagulants
Authors' conclusion
The CG formula plays a crucial role in managing Asian patients with AF in the DOAC era, proving essential for both guiding dosing and predicting adverse clinical events.
Study context
- Population
- Patients with non-valvular atrial fibrillation (AF) receiving direct oral anticoagulants (DOACs) between June 2012 and December 2021patients enrolled
- Participants
- 21,318 patients
- Exposure
- concordance and predictive performance of different renal function formulas regarding clinical outcomes
Methodological detailsmulticenter database in Taiwan
- Multicenter database in Taiwan
Main finding
As reported in the abstract
Normal renal function (≥60 mL/min/1.73 m² (or mL/min)) by formula
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Concordance with CG (weighted Cohen's Kappa) | MDRD K 0.512 (95% CI 0.493–0.530) · CKD-EPI K 0.481 (95% CI 0.462–0.500) |
| Discrimination for major adverse events (AUC) | MDRD AUC 0.641 (95% CI 0.633–0.649) · CKD-EPI AUC 0.664 (95% CI 0.656–0.672) · CG AUC 0.707 (95% CI 0.700–0.714) |
Concordance with Cockcroft-Gault (CG) (weighted Cohen's Kappa)
- Concordance only moderate
Risk of adverse composite outcomes by renal function
- Risk increases exponentially when renal function falls below 60 mL/min/1.73 m² (or mL/min) for the 8 formulas
- For ≥60 mL/min/1.73 m² (or mL/min), the relationship diverged across the 8 formulas
Discrimination for major adverse events (AUC)
- Modification of Diet in Renal Disease (MDRD), CKD-EPI and other renal function equations inferior to CG
Original publication
Different renal function estimation formulas for adverse outcomes in patients with atrial fibrillation receiving direct oral anticoagulants. Heart Rhythm. Published 3 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it