期刊
JOURNAL OF COMPARATIVE EFFECTIVENESS RESEARCH
卷 4, 期 6, 页码 651-664出版社
FUTURE MEDICINE LTD
DOI: 10.2217/cer.15.44
关键词
atrial fibrillation; chronic kidney disease; new oral anticoagulant; nonvitamin K oral anticoagulant; renal function; renal insufficiency; rivaroxaban; vitamin K antagonist
资金
- Boehringer Ingelheim
- Bayer
- Daiichi Sankyo
- Pfizer/Bristol-Myers Squibb
- Pfizer
- Bristol-Myers Squibb
- Astrazeneca
- Abbvie
- Gilead
- Lilly
- Otsuka
- Bayer Spain
Renal insufficiency increases the risk of stroke and bleeding in atrial fibrillation patients. Although vitamin K antagonists reduce the risk of stroke in patients with moderate renal dysfunction, this observation is less clear in patients with renal impairment. Moreover, the risk of bleeding with vitamin K antagonists increases as renal function worsens. Maintaininginternational normalized ratio values within therapeutic targets is more difficult in patients with renal dysfunction, and those agents may cause warfarin-related nephropathy and vascular calcification. Rivaroxaban is the only nonvitamin K oral anticoagulant with a dose specifically tested in patients with moderate renal insufficiency. Rivaroxaban is effective for the prevention of stroke in atrial fibrillation patients with moderate renal dysfunction, with a lower risk of intracranial and fatal bleeding.
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