Arrhythmias & electrophysiologyCohort study
Outcomes of Stroke Prevention Strategies in Patients With Atrial Fibrillation and End-Stage Renal Disease
- Retrospective cohort study
- propensity-score matched
- national database
- multivariable Cox regression
Authors' conclusion
In propensity-matched cohorts of ESRD patients with AF, the composite outcome of stroke or SE, MB, and all-cause mortality was higher in those treated with apixaban or warfarin compared with those who underwent LAAO.
Study context
- Population
- Patients with atrial fibrillation (AF) and end-stage renal disease (ESRD), national database1,947 per matched group
- Participants
- 14,849 patients
- Exposure
- Apixaban vs warfarin vs left atrial appendage occlusion (LAAO)
- LAAOn = 2,360reference
- Apixabann = 4,077
- Warfarinn = 8,412
- Outcome
- Composite of:
- Ischemic stroke/SE
- Major bleeding
- Death
- Follow-up
- Median 0.9 years (Q1-Q3: 0.4-1.6 years)
Main finding
As reported in the abstract
Composite of:
- Stroke/SE
- Major bleeding (MB)
- Death
Each group vs LAAOAdjusted hazard ratio (95% CI)P value
Warfarin
1.26(1.17–1.39)
P < 0.001Apixaban
1.27(1.16–1.39)
P < 0.001Observational data: associations, not effects.
Secondary outcomes
Stroke or SE
- Significantly higher with apixaban and warfarin than LAAO
All-cause mortality
- Similar across the groups
Safety
Major bleeding and gastrointestinal bleeding
- Significantly higher with apixaban and warfarin than LAAO
Intracranial hemorrhage
- Similar across the groups
Original publication
Outcomes of Stroke Prevention Strategies in Patients With Atrial Fibrillation and End-Stage Renal Disease. JACC Cardiovasc Interv. Published 14 October 2025. doi:10.1016/j.jcin.2025.07.038
Summarised from the published abstract; every number is checked against it