MO162: Renal Function During Long-Term Use of Oral Anticoagulants in Patients with Atrial Fibrillation

Abstract

Abstract BACKGROUND AND AIMS Long-term oral anticoagulant should be recommended in patients with atrial fibrillation (AF) and CHA2DS2VASc score ≥ 1 for stroke prevention. Warfarin and different direct oral anticoagulants are metabolized differently by the kidney. The impact on renal function during long-term use of oral anticoagulants in the patients with AF remains unclear. The aim of our study was to compare rivaroxaban's and warfarin's impact on the decline in renal function in patients with AF. METHOD This study included patients with non-valvular AF from 2016 to 2020, mainly through the medical history of the Republican nephrology inpatient departments. Baseline estimated glomerular filtration rate (eGFR), follow-up eGFR and the change in eGFR between 2-year eGFR and baseline eGFR were compared between different anticoagulants after propensity score matching. The primary study endpoint was acute kidney injury (AKI). A total of 289 patients were enrolled (n = 131 rivaroxaban, n = 158 warfarin) in this study, and the mean observation time was 2.9 ± 0.8 years. RESULTS During the observation period, there was a significantly higher incidence of AKI during follow-up in the warfarin group than in the rivaroxaban group before and after propensity score matching (before: warfarin versus rivaroxaban: 8.9% versus 4.6%, P < .001; after: warfarin versus rivaroxaban: 8.2% versus 3.8%, P < .001). The change in eGFR between 2-year eGFR and baseline eGFR did not differ between the warfarin and rivaroxaban groups after propensity score matching (warfarin versus rivaroxaban: − 1.31 ± 20.31 versus –1.82 ± 16.23 mL/min/1.73 m2, P = .452). CONCLUSION During the mean observation time of 2.9 ± 0.8 years, warfarin was associated with a higher incidence of AKI compared with rivaroxaban. The decline in renal function did not differ among warfarin and rivaroxaban groups.