Renal function considerations for stroke prevention in atrial fibrillation.

Link to article at PubMed

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Renal function considerations for stroke prevention in atrial fibrillation.

Am J Med. 2017 May 11;:

Authors: Fanikos J, Burnett AE, Mahan CE, Dobesh PP

Abstract
Renal impairment increases risk of stroke and systemic embolic events and bleeding in patients with atrial fibrillation. Direct oral anticoagulants have varied dependence on renal elimination, magnifying the importance of appropriate patient selection, dosing, and periodic kidney function monitoring. In randomized controlled trials of nonvalvular atrial fibrillation, direct oral anticoagulants were at least as effective and associated with less bleeding compared with warfarin. Each direct oral anticoagulant was associated with reduced risk of stroke and systemic embolic events and major bleeding compared with warfarin in nonvalvular atrial fibrillation patients with mild or moderate renal impairment. Renal function decline appears less impacted by direct oral anticoagulants, which are associated with a better risk-benefit profile than warfarin in patients with declining renal function over time. Limited data address the risk-benefit profile of direct oral anticoagulants in patients with severe impairment or on dialysis.

PMID: 28502818 [PubMed - as supplied by publisher]

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