Warfarin for a-fib does not worsen outcomes for patients with kidney disease

March 4, 2014

Although some research has suggested that the use of the anticoagulant warfarin for atrial fibrillation among patients with chronic kidney disease would increase the risk of death or stroke, a study that included more than 24,000 patients found a lower l-year risk of the combined outcomes of death, heart attack or stroke without a higher risk of bleeding, according to a study in the March 5 issue of JAMA.

Juan Jesus Carrero, Ph.D., of the Karolinska Institutet, Stockholm, and colleagues examined outcomes associated with warfarin treatment in relation to kidney function among patients with established cardiovascular disease and atrial fibrillation. Using data from a Swedish registry, the study included survivors of a with atrial fibrillation and known measures of serum creatinine (n = 24,317; a substance used to measure kidney function), including 21.8 percent who were prescribed warfarin at discharge.

About 52 percent of patients had moderate (CKD) or worse. The researchers found that was associated with a lower l-year risk of a composite of the outcomes of death, heart attack, and ischemic stroke without a higher risk of bleeding. This association was observed in patients with moderate, severe, or end-stage CKD. The number of patients who developed the composite outcome, bleeding events, and the total of these 2 outcomes increased with the worsening of CKD categories, as did the rate at which these events occurred.

Wolfgang C. Winkelmayer, M.D., M.P.H., Sc.D., and Mintu P. Turakhia, M.D., M.A.S., of the Stanford University School of Medicine, Palo Alto, Calif., (Dr. Winkelmayer is also an Associate Editor, JAMA), comment on the findings of this study in an accompanying editorial.

"In conclusion, the study by Carrero et al in this issue of JAMA provides the best evidence to date that vitamin K antagonists [anticoagulants] are associated with improved clinical outcomes and no significant increased risk of bleeding in patients with myocardial infarction and with advanced CKD."

Explore further: Chronic kidney disease increases stroke risk in A-fib

More information: DOI: 10.1001/jama.2014.1334
DOI: 10.1001/jama.2014.1781

Related Stories

Chronic kidney disease increases stroke risk in A-fib

August 16, 2012

(HealthDay) -- Patients with atrial fibrillation who have chronic kidney disease are at higher risk of stroke or systemic thromboembolism and bleeding, according to a study published in the Aug. 16 issue of the New England ...

Recommended for you

Smoking leaves lasting marks on DNA, study finds

September 20, 2016

(HealthDay)—Smoking cigarettes can leave a lasting imprint on human DNA, altering more than 7,000 genes in ways that may contribute to the development of smoking-related diseases, a new study says.

Sleep disorders may influence heart disease risk factors

September 20, 2016

Sleep problems including sleeping too little or too long, may be linked to a variety of factors that may raise the risk for cardiovascular diseases, according to a new American Heart Association scientific statement published ...

Sleep troubles, heart troubles?

September 20, 2016

(HealthDay)—Sleep disorders—including too little or too much sleep—may contribute to heart disease risk factors, the American Heart Association said in its first statement on the risks of sleep problems.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.