Decline in Renal Function Can Vary With Anticoagulants in A-Fib Patients

(HealthDay News) — For patients with atrial fibrillation, decline in renal function is significantly greater with warfarin vs. dabigatran etexilate (DE), according to a study published in the June 16 issue of the Journal of the American College of Cardiology.

Michael Böhm, MD, from the Universitätsklinikum des Saarlandes in Homburg, Germany, and colleagues examined changes in glomerular filtration rate (GFR) during long-term treatment with warfarin or DE in 18,113 patients enrolled in the Randomized Evaluation of Long Term Anticoagulation Therapy trial. Participants were randomized to DE (110mg or 150mg twice daily) or warfarin and followed for up to 30 months.

The researchers observed a decrease in GFR in all treatment groups. The mean decline in GFR was significantly greater with warfarin (−3.68ml/min) vs. DE 110mg (−2.57ml/min; P=0.0009 vs. warfarin) or DE 150mg (−2.46ml/min; P=0.0002 vs. warfarin), after an average of 30 months. In the observation period >18 months, the likelihood of a decrease in GFR >25% was lower with DE 110mg (hazard ratio, 0.81; P=0.017) or DE 150mg (hazard ratio, 0.79; P=0.0056) vs. warfarin. The decline in GFR was more pronounced with previous warfarin use and presence of diabetes.

“Patients with atrial fibrillation receiving oral anticoagulation exhibited a decline in renal function that was greater in those taking warfarin vs. DE, and it was amplified by diabetes and previous vitamin K antagonist use,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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