Rivaroxaban vs Vitamin K Antagonist in Patients With Atrial Fibrillation and Advanced Chronic Kidney Disease
Main finding · Adverse kidney outcomesResult — go to the resultHazard ratio 0.62 95% CI 0.43–0.88Authors' conclusion
In patients with AF and advanced chronic kidney disease, those receiving rivaroxaban had less adverse kidney events and lower all-cause mortality compared to those receiving VKA
Study context
- Population
- Patients with atrial fibrillation (AF) and advanced CKD (estimated glomerular filtration rate (eGFR) 15 to 49 mL/min/1.73 m²)mean age 78 years
- Participants
- 1,455 patients
- Exposure
- Rivaroxaban vs VKA
- Rivaroxabann = 764
- VKAn = 691reference
- Outcome
- Adverse kidney outcomes:
- eGFR decline to <15 mL/min/1.73 m²
- Need for chronic kidney replacement therapy
- AKI
- Follow-up
- Median 2.1 years
Methodological detailspropensity score overlap weighting, blinded adjudicated outcomes
- Propensity score overlap weighting
- Blinded adjudicated outcomes
Main finding
Adverse kidney outcomes
Hazard ratio
0.62
95% CI 0.43–0.88
Rivaroxabanvs VKA
HR 0.62 (95% CI 0.43–0.88)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause death · median follow-up 2.1 years | 0.76 (0.59–0.98) | |
| 0.512Hazard ratio (log scale) |
Net clinical benefit (stroke or systemic embolism, major bleeding, MI, ACS or CV death)
- No significant differences in net clinical benefit
Original publication
Rivaroxaban vs Vitamin K Antagonist in Patients With Atrial Fibrillation and Advanced Chronic Kidney Disease. JACC Adv. Published 5 January 2024. doi:10.
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