Abstract: TH-PO218
Survival Benefit of Anticoagulation in Patients with ESKD and Atrial Fibrillation
Session Information
- Hypertension and CVD: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Choi, Soo yeon, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Lee, Jun Young, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Shin, Donghui, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Kim, Jae seok, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Han, Byoung Geun, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
Background
Prevalence of atrial fibrillation (AF) in patients with end stage kidney disease (ESKD) is high and increasing, however, current evidence is insufficient and conflicting regarding oral anticoagulant (OAC) use in patients with ESKD and AF.
Methods
A retrospective cohort study of patients diagnosed with AF after ESKD was conducted using the Korea National Health Insurance System Database from January 2007 to December 2017.
Results
Compared with OAC nonuser OAC user were associated with lower risk of all-cause death (hazard ratios (HR) 0.71; 95% confidence interval (CI) 0.58-86), ischemic stroke (HR 0.63; 95% CI 0.43-92), and MACE (HR 0.76; 95% CI 0.59-0.98) without increased risk of severe bleeding (HR 1.58; 95% CI 0.99-2.52). Patients used direct OAC showed significantly lower risk of all-cause death (HR 0.44; 95% CI 0.28-0.69), ischemic stroke (HR 0.36; 95% CI 0.13-0.99), and MACE (HR 0.42; 95% CI 0.22-0.79) than those of OAC-nonuser, but no association with severe bleeding (HR 0.26; 95% CI 0.04-1.90).
Conclusion
In patients with ESKD and AF, OACs were associated with reduced all-cause death, ischemic stroke, and MACE risks.
Subgroup analysis for all-cause mortality, ischemic stroke, severe bleeding, and MACE according to type of oral anticoagulant.