Abstract
Introduction. Vitamin K antagonists (VKAs) and non – vitamin K antagonist oral anticoagulants (NOACs) are used in the treatment of atrial fibrillation for prevention of thromboembolic events. Materials and methods. We studied 389 patients (45.8 % female) with NVAF, who have been taking apixaban (12.6 %), dabigatran (38.6 %), rivaroxaban (26.7 %) and acenocoumarol (22.1 %). Creatinine levels were controlled after 2, 6 and 12 months. We worked out estimated glomerular filtration rate (eGFR) by means of Chronic Kidney Disease Epidemiology Collaboration (CKD – EPI) equation. Results. The changes in creatinine and eGFR values after 2, 6, 12 months in all 4 subgroups were statistically significant. Post hoc tests showed changes in creatinine and eGFR values after 2, 6, 12 months for apixaban, dabigatran and rivaroxaban compared with acenocoumarol. Three NOACs were associated with > = 20% decline in eGFR (hazard ratio [HR]: 0.24; 95 % CI: 0.16 - 0.37; p = 30 % increase in creatinine concentration ([HR]: 0.19; 95 % CI: 0.11 – 0.32; p < 0.001) and eGFR < 44 ml/min/1.73 m2 ([HR]: 0.24; 95 % CI: 0.11 – 0.55; p = 0.002). Conclusion. Using of NOACs is connected with more positive effects of renal outcomes than treatment with acenocoumarol.
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