Antithrombotic Therapy in Patients with Atrial Fibrillation and Chronic Kidney Disease
MAY 14, 2015
Niki Katsiki, MSc, PhD, MD, FRSPH, and Dimitri P. Mikhailidis, MD, FFPM, FRCP, FRCPath
Niki Katsiki, MSc, PhD, MD, FRSPH
Bonde AN, Lip GY, Kamper AL, et al. Net clinical benefit of antithrombotic therapy in patients with atrial fibrillation and chronic kidney disease: a nationwide observational cohort study. J Am Coll Cardiol. 2014;64(23):2471-2482.
The presence of chronic kidney disease (CKD) in patients with atrial fibrillation (AF) increases the risk of stroke and thromboembolism (TE) as well as the risk of bleeding, thus complicating their treatment. In this context, it has been suggested that CKD should be included in the CHA2DS2-VASc (Congestive heart failure; Hypertension; Age ≥75 years; Diabetes mellitus; previous Stroke, transient ischemic attack, or thromboembolism; Vascular disease; Age 65 to 74 years; Sex category) score. In the present study, Bonde et al1 evaluated the net clinical benefit of warfarin therapy as assessed by composite end points of death/hospitalization from stroke/bleeding, cardiovascular death, and all-cause mortality in nonvalvular AF patients with CKD (both non–end-stage and end-stage treated with renal replacement therapy).