Arrhythmias & electrophysiology
Efficacy and safety of oral anticoagulants according to kidney function among patients with atrial fibrillation
Authors' conclusion
Overall, we found no differences regarding the risk of stroke/TE, but apixaban was associated with a 21% lower relative risk of major bleeding compared to VKA.
Study context
- Population
- Patients with AF initiated on OAC with available creatinine level, across kidney function subgroups
- Participants
- 26,686 patients
- Exposure
- Direct oral anticoagulants (DOACs) vs vitamin K antagonists (VKA) by kidney function
- Outcome
- Stroke/thromboembolism and major bleeding
- Follow-up
- 2 years
Methodological detailsDanish nationwide registers
- Danish nationwide registers
Main finding
As reported in the abstract
Stroke/TE and major bleeding by kidney function subgroup
Hazard ratio (95% CI)
Apixaban vs VKAmajor bleeding; risk difference larger with reduced kidney function (interaction P 0.018)
0.79(0.67–0.93)
Rivaroxaban vs Apixabanbleeding, eGFR 30-49 mL/min/1.73 m²
1.78(1.32–2.39)
- No evidence of differences in stroke/TE risk between the oral anticoagulants (OACs)
- P for interaction > 0.05 for all
- Estimated glomerular filtration rate (eGFR) 30-49 mL/min/1.73 m²
- 3667 (13.7%)
- eGFR below 30 mL/min/1.73 m²
- 596 (2.2%)
Observational data: associations, not effects.
Original publication
Efficacy and safety of oral anticoagulants according to kidney function among patients with atrial fibrillation. Eur Heart J Cardiovasc Pharmacother. Published 24 February 2024. doi:10.
Summarised from the published abstract; every number is checked against it