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. 2022 Dec 17;10(12):2566.
doi: 10.3390/healthcare10122566.

Oral Anticoagulation in Patients with Chronic Kidney Disease and Non-Valvular Atrial Fibrillation: The FAERC Study

Marco Montomoli  1 , Lourdes Roca  2 , Mariana Rivera  3 , Raul Fernandez-Prado  4 , Beatriz Redondo  5 , Rosa Camacho  6 , Cayetana Moyano  7 , Saul Pampa  8 , Angela Gonzalez  9 , Juan Casas  10 , Maria Kislikova  11 , Ana Sanchez Horrillo  12 , Alicia Cabrera Cárdena  12 , Borja Quiroga  12 , Cristina Rabasco  7 , Sara Piqueras  13 , Andrea Suso  6 , Javier Reque  14 , Juan Villa  15 , Raquel Ojeda  7 , David Arroyo  9
Affiliations

Oral Anticoagulation in Patients with Chronic Kidney Disease and Non-Valvular Atrial Fibrillation: The FAERC Study

Marco Montomoli et al. Healthcare (Basel). .

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in patients with chronic kidney disease (CKD), and its presence is associated with a higher risk of stroke and mortality.

Material and methods: The FAERC study performed a retrospective multicentre analysis of historical cohorts in which data were collected from arrhythmia diagnosis onwards.

Results: We analysed a Spanish cohort of 4749 patients with CKD (mean eGFR 33.9 mL/min) followed up in the nephrology clinic, observing a 12.2% prevalence of non-valvular AF. In total, 98.6% of these patients were receiving anticoagulant treatment, mainly with coumarins (79.7%). Using direct-acting oral anticoagulants (DOACs) was associated with fewer cerebrovascular events than using acenocoumarol, but in contrast with other studies, we could not corroborate the association of risk of bleeding, coronary events, or death with a type of anticoagulant prescribed.

Conclusions: Atrial fibrillation is highly prevalent in renal patients. Direct-acting anticoagulants seem to be associated with fewer ischemic-embolic complications, with no differences in bleeding, coronary events, or mortality rates.

Keywords: atrial fibrillation; chronic kidney disease; coumarins; direct-action anticoagulants; haemorrhage; ischemic stroke; mortality; prevalence.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Effect of (a) previous cerebrovascular events and (b) the use of coumarins compared to DOACS were associated with a higher risk of ischemic and embolic events in the Cox regression model. Abbreviations: DOACS: direct-acting oral anticoagulants. CVE: cerebrovascular event. AC: adjustment for censoring. VKAS: vitamin K antagonist anticoagulants.
Figure 2
Figure 2
Evolution of renal function depending on the type of anticoagulant: The drop in eGFR in the first year of treatment was greater in the DOAC than VKAs group. However, we did not observe a relationship between anticoagulant type and rate of renal progression throughout follow-up. Abbreviations: eGFR: estimated glomerular filtration rate. DOACs: direct-acting oral anticoagulants. AVK: vitamin K antagonist anticoagulants.
See this image and copyright information in PMC

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