#2964 THE ROLE OF RENAL DYSFUNCTION DURING ANTICOAGULANT USE IN COPD PATIENTS WITH ATRIAL FIBRILLATION

Abstract

Abstract Background and Aims Renal dysfunction is known to be the most important predictor of outcome in patients with atrial fibrillation (AF). Purpose of the study was to evaluate the prognostic role of kidney dysfunction in terms of possible cardiovascular events and bleeding in patients with COPD and AF treated with oral anticoagulants. Method We examined 56 COPD patients with CHF and AF who received oral anticoagulants. Renal function (creatinine level and estimated glomerular filtration rate - eGFR) was assessed at baseline and at follow-up. The functional state of the kidneys was calculated using the CKD-EPI-2011 formula. Initially, the risk of bleeding was assessed using the HAS-BLED score. The deterioration of the functional state of the kidneys was noted with an increase in the level of creatinine or a decrease in eGFR by at least 20%. Results In addition to the standard treatment for COPD in the presence of AF, patients received oral anticoagulants during a six-month follow-up. The deterioration of the functional state of the kidneys was observed in 18.3% of patients. In patients with kidney dysfunction, the frequency of episodes of CHF decompensation and non-massive bleeding (MB) was significantly higher. When reduced glomerular filtration rate did not affect the frequency of bleeding and stroke. The oral anticoagulants used did not significantly affect the observed renal dysfunction and did not affect the occurrence of new cardiovascular events in patients with COPD. It turned out that the predictors of renal dysfunction in patients with COPD are age, female gender, and lower hemoglobin levels. In multivariate analysis, renal dysfunction was identified as an independent predictor of non-massive bleeding (OR 2.04, 95%, p<0.05). Conclusion In patients with COPD and atrial fibrillation, the presence of kidney dysfunction was an additional aggravating factor associated with adverse cardiovascular prognosis in the medium term and the risk of bleeding. However, oral anticoagulants did not affect the degree of deterioration in renal function or the incidence of cardiovascular events.