Cardiac and renal outcomes of direct oral anticoagulants in patients with atrial fibrillation

Yu Ting Wang, Jo Hsin Chen, Shu Fen Liao, Yu Jen Chen, Gregory Y.H. Lip, Jong Shiuan Yeh

研究成果: 雜誌貢獻文章同行評審

1 引文 斯高帕斯(Scopus)


Background: Oral anticoagulation therapy with warfarin or direct oral anticoagulants (DOACs) is the mainstay for stroke prevention in patients with non-valvular atrial fibrillation (AF). The DOACs might have a lower risk of declining renal function than warfarin. This study aimed to compare renal outcomes among rivaroxaban, edoxaban, dabigatran, and warfarin. Method: This cohort study identified 2203 adults with AF who started anticoagulation therapy between 1 July 2013 and 31 December 2020, in a clinical database at a single centre. Inverse probability of treatment weighting was adopted to balance baseline characteristics among four anticoagulants treatment groups. The primary outcome was a composite of cardiac and renal outcomes, involving a ≥30% decline in estimated glomerular filtration rate (eGFR), renal failure and cardiovascular death. Results: After propensity score weighting, dabigatran was associated with significantly lower risks of a ≥30% decline in eGFR (hazard ratio [HR]:.69, 95% confidence interval [CI]:.497–.951, p =.0237), doubling of the serum creatinine level (HR:.49, 95% CI:.259–.927, p =.0282) and the cardiac and renal outcome composite (HR:.67, 95% CI:.485–.913, p =.0115) than warfarin. Rivaroxaban and edoxaban did not show significant protective effects on renal outcomes compared to warfarin. Conclusion: In this study, patients treated with dabigatran had significantly reduced risks of declining renal function and composite cardiac and renal events than those treated with warfarin. However, rivaroxaban and edoxaban were not associated with lower risks of any renal outcomes than warfarin. More studies are warranted to investigate and compare the impact of renal function between different DOACs in patients with AF.
期刊European Journal of Clinical Investigation
出版狀態已發佈 - 1月 2024

ASJC Scopus subject areas

  • 生物化學
  • 臨床生物化學


深入研究「Cardiac and renal outcomes of direct oral anticoagulants in patients with atrial fibrillation」主題。共同形成了獨特的指紋。