Renal function and oral anticoagulant treatment of incident non-valvular atrial fibrillation: a retrospective study

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Sreeram V Ramagopalan1, Elaine Stamp2, Cormac J Sammon2

  • 1Centre for Observational Research & Data Sciences, Bristol-Myers Squibb, UB8 1DH, UK.

Future Cardiology
|May 30, 2019
PubMed

Insights

Most patients newly diagnosed with non-valvular atrial fibrillation have renal dysfunction. Oral anticoagulant (OAC) treatment initiation is lower in those with severe kidney impairment, indicating a need for more research.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Non-valvular atrial fibrillation (NVAF) is a common condition requiring anticoagulation.
  • Renal function significantly impacts cardiovascular disease management and drug efficacy.
  • Understanding renal function in NVAF patients is crucial for appropriate treatment strategies.

Purpose of the Study:

  • To assess the renal function of newly diagnosed NVAF patients in England.
  • To investigate the patterns of oral anticoagulant (OAC) prescription based on renal function in this population.

Main Methods:

  • A cohort of 18,419 individuals with NVAF was identified.
  • Renal function was assessed at the time of diagnosis.
  • Prevalence of OAC treatment initiation within six months post-diagnosis was analyzed according to renal function categories.

Main Results:

  • A significant majority (79%) of NVAF patients exhibited some degree of renal dysfunction.
  • 12% of patients presented with severe renal dysfunction (glomerular filtration rate <30 ml/min/1.73 m²).
  • OAC initiation was less frequent in patients with severe renal dysfunction compared to those with normal renal function.

Conclusions:

  • The high prevalence of renal dysfunction in newly diagnosed NVAF patients is a key finding.
  • Lower OAC treatment rates in patients with severe renal dysfunction suggest potential undertreatment.
  • Further evidence is needed to guide optimal OAC use in NVAF patients with impaired renal function.

Keywords:
Clinical Practice Research DatalinkHospital Episode Statisticschronic kidney diseaseend-stage renal diseasenon-valvular atrial fibrillationoral anticoagulants

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