Influence of renal function on vitamin K antagonist oral anticoagulation quality in non-valvular atrial fibrillation patients - 06/01/20
Résumé |
Introduction |
Chronic kidney disease (CKD) has been related to poor quality of anticoagulation and an increased risk of bleeding. This study aims to evaluate the association between impaired renal function (eGFR <60mL/min/1.73 m2) and anticoagulation control in patients with non-valvular atrial fibrillation (AF) on vitamin K antagonists (VKA) therapy.
Methods |
This is an ancillary analysis of the prospective NATURE AF registry (NAtionalTUnisianREgistry of Atrial Fibrillation). Between March and June 2017, we prospectively registered information of 912 patients with a recently diagnosed AF and they were followed for one year. Patients with CKD were in turn categorized according to their eGFR level (Stage 3A: 59–45mL/min, Stage 3B: 44–30mL/min, Stage 4:29-15mL/min and Stage 5: <15mL/min). The calculations for the time in therapeutic range (TTR) were made for the 12 months in each group and compared with the TTR of patients without CKD.
Results |
A total of 103 patients (11.4%) had eGFR <60mL/min/1.73 m2. Anticoagulation control levels progressively worsened across each stage of CKD till the stage 3B then it progressively improved in stages 4 and 5. In the subgroup of patients with preserved renal function (75.5%), the concomitant use of anti-platelet agents was associated with better TTR (Table 1).
Conclusions |
Early stages of CKD seem to be associated with poorer anticoagulation control in patients with non-valvular AF taking VKA but without statistically significant difference. Larger studies with longer follow-up are necessary.
Le texte complet de cet article est disponible en PDF.Plan
Vol 12 - N° 1
P. 125-126 - janvier 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.