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ARTICLE CONTRIBUTORS

American Journal of Cardiology

Clinical Articles, News & Views

Renal impairment in anticoagulated patients with AF

The presence of impaired renal function is closely related to thrombotic/vascular events, bleeding, and mortality in anticoagulated patients with atrial fibrillation (AF), according to a study1 published recently in the American Journal of Cardiology.

Researchers evaluated the effect of renal function on prognosis in anticoagulated patients with AF and assessed the changes in renal function during a long-term follow-up period. They recruited 978 consecutive stable anticoagulated patients with AF from an outpatient anticoagulation clinic (international normalised ratio 2.0 to 3.0 within the previous 6 months).

The estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease equation at inclusion and 2 years of follow-up. Adverse events were recorded during follow-up (thrombotic/vascular events, major bleeding episodes, and mortality). Longitudinal changes in renal function were analysed in 886 patients (90.6%). At baseline, the median eGFR using the Modification of Diet in Renal Disease equation was 70.24 ml/min/1.73 m2 (interquartile range 46.79 to 72.52).

During follow-up, a low eGFR was associated with thrombotic/vascular events, with every 30 ml/min/1.73 m2 eGFR decrease (p = 0.006), bleeding (p = 0.015), and mortality (p = 0.004). After excluding patients with a baseline eGFR <30 ml/min/1.73 m2, the mean eGFR in our cohort decreased >10 ml/min/1.73 m2 in 181 patients (21%) during the follow-up period.

The variables associated with severe renal impairment during follow-up were heart failure (p = 0.010), basal eGFR (p <0.001), and CHADS2 score (p = 0.003).

Save the date!

8th Annual Scientific Meeting of the Cardiorenal Forum

Clinical dilemmas in cardiorenal disease and co-morbidities

Friday 4th October 2013

Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regent’s Park, London NW1 4RG

This year’s Scientific Meeting will include presentations on:

• Cardiovascular effects of drugs for diabetes and obesity

• Advanced imaging and diagnostics in cardiorenal disease

• Renal sympathetic denervation

• Anticoagulation in patients with renal dysfunction

• Reviews of recent cardiac and renal clinical trials.

Full details and registration available soon at www.cardiorenalforum.com

References

1. Roldán V, Marín F, Fernández H, et al. Renal impairment in a “real-life” cohort of anticoagulated patients with atrial fibrillation (implications for thromboembolism and bleeding). Am J of Cardiol 2013. http://dx.doi.org/10.1016/j.amjcard.2012.12.045

Published on: February 28, 2013

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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