Scholarlink

Background <p>Literature has reported more significant deterioration of renal function in non-valvular atrial fibrillation (NVAF) patients treated with warfarin. This study aimed to assess the incidence of clinically significant renal function decline (≥ 30% decline in estimated glomerular filtration rate) following warfarin initiation in Asian NVAF patients and identify its predictors.</p> Results <p>We analyzed 481 patients with a mean age of 68.7 ± 10.2&#xa0;years. Most (n = 312, 64.9%) patients have underlying chronic kidney disease during warfarin initiation. The duration of warfarin treatment ranged from 1 to 9&#xa0;years, with a mean of 3.2 ± 1.7&#xa0;years. Clinically significant eGFR decline occurred in 88 (18.3%) patients and was not associated with ischemic stroke/transient ischemic attack (p = 0.245); however, it was positively associated with major bleeding (p = 0.012). Overall, female sex (aOR 2.146, 95%CI 1.272–3.623, p = 0.004), diabetes mellitus (aOR 1.784, 95%CI 1.072–2.970, p = 0.026), heart failure (aOR 2.161, 95%CI 1.267–3.687, p = 0.005), alpha-blocker use (aOR 2.566, 95%CI 1.097–6.002, p = 0.030), time in therapeutic range (TTR) &lt; 60% (aOR 2.833, 95%CI 1.675–4.785, p &lt; 0.001) and warfarin treatment duration in year (aOR 1.244, 95%CI 1.081–1.431, p = 0.002) were the predictors of clinically significant eGFR decline.</p> Conclusion <p>Clinically significant renal function decline is common among Malaysian NVAF patients on warfarin treatment and was associated with an increased risk of major bleeding, highlighting the crucial need for periodic renal function monitoring in these patients. The identified predictors can help identify NVAF patients at high risk of renal function decline with warfarin and guide OAC selection to avoid adverse kidney outcomes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Incidence and predictors of clinically significant renal function decline among Asian non-valvular atrial fibrillation patients on warfarin

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年1月24日

查看全文
  • Hock Peng Koh,
  • Jiaa Yinn Tang,
  • Szu Lynn Tay,
  • Jivanraj R. Nagarajah,
  • Pradeep Kumar Nair Arumugam

摘要

Background

Literature has reported more significant deterioration of renal function in non-valvular atrial fibrillation (NVAF) patients treated with warfarin. This study aimed to assess the incidence of clinically significant renal function decline (≥ 30% decline in estimated glomerular filtration rate) following warfarin initiation in Asian NVAF patients and identify its predictors.

Results

We analyzed 481 patients with a mean age of 68.7 ± 10.2 years. Most (n = 312, 64.9%) patients have underlying chronic kidney disease during warfarin initiation. The duration of warfarin treatment ranged from 1 to 9 years, with a mean of 3.2 ± 1.7 years. Clinically significant eGFR decline occurred in 88 (18.3%) patients and was not associated with ischemic stroke/transient ischemic attack (p = 0.245); however, it was positively associated with major bleeding (p = 0.012). Overall, female sex (aOR 2.146, 95%CI 1.272–3.623, p = 0.004), diabetes mellitus (aOR 1.784, 95%CI 1.072–2.970, p = 0.026), heart failure (aOR 2.161, 95%CI 1.267–3.687, p = 0.005), alpha-blocker use (aOR 2.566, 95%CI 1.097–6.002, p = 0.030), time in therapeutic range (TTR) < 60% (aOR 2.833, 95%CI 1.675–4.785, p < 0.001) and warfarin treatment duration in year (aOR 1.244, 95%CI 1.081–1.431, p = 0.002) were the predictors of clinically significant eGFR decline.

Conclusion

Clinically significant renal function decline is common among Malaysian NVAF patients on warfarin treatment and was associated with an increased risk of major bleeding, highlighting the crucial need for periodic renal function monitoring in these patients. The identified predictors can help identify NVAF patients at high risk of renal function decline with warfarin and guide OAC selection to avoid adverse kidney outcomes.