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Open AccessArticle

Safety and Efficacy of Direct Oral Anticoagulants for Atrial Fibrillation in Patients with Renal Impairment

1
Department of Pharmacy Practice, Loma Linda University School of Pharmacy; Loma Linda, CA 92350, USA
2
Department of Pharmaceutical and Administrative Sciences, Loma Linda University School of Pharmacy; Loma Linda, CA 92350, USA
*
Author to whom correspondence should be addressed.
Pharmacy 2020, 8(1), 30; https://doi.org/10.3390/pharmacy8010030
Received: 18 January 2020 / Revised: 26 February 2020 / Accepted: 29 February 2020 / Published: 4 March 2020
(This article belongs to the Special Issue Pharmacokinetics of Drugs and Dosing in Kidney Disease)
Direct oral anticoagulants (DOACs) are gaining popularity for patients with nonvalvular atrial fibrillation (AF) for stroke prevention. Less bleeding risk with comparable stroke prevention compared to warfarin was shown. DOACs have predictable anticoagulant effects, infrequent monitoring requirements and less drug-food interactions compared to warfarin. However, safety and efficacy data of DOACs in patients with chronic kidney disease (CKD) are limited. This is a retrospective study to evaluate thromboembolic and bleeding events in patients with AF (with/without CKD) in October 2010 and July 2017. A total of 495 patients were included and only 150 patients had CKD. Our study found that patients with renal impairment on a DOAC do not have a higher incidence of bleeding events. It showed significant increase in thromboembolic events in CKD patients with dabigatran compared to CKD patients with apixaban with odds ratio of 6.58 (95%CI 1.35–32.02, p = 0.02). View Full-Text
Keywords: atrial fibrillation; chronic kidney disease; stroke prevention; thromboembolic; bleeding atrial fibrillation; chronic kidney disease; stroke prevention; thromboembolic; bleeding
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Jang, S.M.; Bahjri, K.; Tran, H. Safety and Efficacy of Direct Oral Anticoagulants for Atrial Fibrillation in Patients with Renal Impairment. Pharmacy 2020, 8, 30.

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