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Changes in Renal Fu...
Changes in Renal Function in Patients With Atrial Fibrillation An Analysis From the RE-LY Trial
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Boehm, Michael (author)
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Ezekowitz, Michael D. (author)
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Connolly, Stuart J. (author)
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Eikelboom, John W. (author)
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Hohnloser, Stefan H. (author)
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Reilly, Paul A. (author)
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Schumacher, Helmut (author)
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Brueckmann, Martina (author)
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Schirmer, Stephan H. (author)
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Kratz, Mario T. (author)
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Yusuf, Salim (author)
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Diener, Hans-Christoph (author)
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- Hijazi, Ziad (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Wallentin, Lars (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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(creator_code:org_t)
- Elsevier BV, 2015
- 2015
- English.
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In: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 65:23, s. 2481-2493
- Related links:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND Vitamin K-dependent factors protect against vascular and renovascular calcification, and vitamin K antagonists may be associated with a decreased glomerular filtration rate (GFR). OBJECTIVES This study analyzed changes in GFR during long-term treatment with warfarin or dabigatran etexilate (DE) in patients enrolled in the RE-LY (Randomized Evaluation of Long Term Anticoagulation Therapy) trial. METHODS Of the 18,113 patients in the RE-LY study randomized to receive DE (110 mg or 150 mg twice daily) or warfarin, 16,490 patients with atrial fibrillation had creatinine values measured at baseline and at least 1 follow-up visit. Changes in GFR for up to 30 months were evaluated. RESULTS GFR declined in all treatment groups. After an average of 30 months, the mean +/- SE decline in GFR was significantly greater with warfarin (-3.68 +/- 0.24 ml/min) compared with DE 110 mg (-2.57 +/- 0.24 ml/min; p = 0.0009 vs. warfarin) and DE 150 mg (-2.46 +/- 0.23 ml/min; p = 0.0002 vs. warfarin). A decrease in GFR >25% was less likely with DE 110 mg (hazard ratio: 0.81 [95% confidence interval: 0.69 to 0.96]; p = 0.017) or DE 150 mg (hazard ratio: 0.79 [95% confidence interval: 0.68 to 0.93]; p = 0.0056) than with warfarin in the observation period >18 months. Patients with poor international normalized ratio control (i.e., time in therapeutic range <65%) exhibited a faster decline in GFR. A more pronounced decline in GFR was associated with previous warfarin use and with the presence of diabetes. CONCLUSIONS Patients with atrial fibrillation receiving oral anticoagulation exhibited a decline in renal function that was greater in those taking warfarin versus DE, and it was amplified by diabetes and previous vitamin K antagonist use.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- anticoagulation
- atrial fibrillation
- renal function
- thrombin inhibition
- vitamin K antagonist
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Boehm, Michael
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Ezekowitz, Micha ...
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Connolly, Stuart ...
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Eikelboom, John ...
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Hohnloser, Stefa ...
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Reilly, Paul A.
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show more...
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Schumacher, Helm ...
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Brueckmann, Mart ...
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Schirmer, Stepha ...
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Kratz, Mario T.
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Yusuf, Salim
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Diener, Hans-Chr ...
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Hijazi, Ziad
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Wallentin, Lars
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Journal of the A ...
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Uppsala University