Renal Impairment in a “Real-Life” Cohort of Anticoagulated Patients With Atrial Fibrillation (Implications for Thromboembolism and Bleeding)

Risk of Thromboembolic Events in Atrial Fibrillation With Chronic Kidney Disease

“…For example, increasing age and heart failure are independently associated with low eGFR. 44 However, our result found that …”

Renal Dysfunction, Stroke Risk Scores (CHADS 2 , CHA 2 DS 2 -VASc, and R 2 CHADS 2 ), and the Risk of Thromboembolic Events After Catheter Ablation of Atrial Fibrillation

“…In the real-life cohorts studying a broad range of stroke risk, renal function, and nonanticoagulated subjects, an independent additive value of renal dysfunction to risk scores for TE was not found. 30,32 In accordance with some previous studies, we found that CHADS 2 and CHA 2 DS 2 -VASc scores had strong predictive value for TE during midterm followup in nonvalvular AF. 4,11 A new observation in our study was the use of R 2 CHADS 2 in the prediction of TE, but there was no added advantage of this score compared with the classic CHADS 2 and CHA 2 DS 2 -VASc scores.…”

“…25 In another study, eGFR <60 mL/min per 1.73 m 2 was a significant predictor of stroke and cardiovascular events among patients with AF, independent of the CHADS 2 score, 29 in accordance with recently published studies. 25,30 Despite the known association between renal dysfunction and TE in AF, renal dysfunction has not been included in any of the current stroke stratification schemes although it was previously proposed that the small c in CHA 2 DS 2 -VASc score could represent informally chronic renal impairment. 31 In 2012, Piccini et al 12 proposed the R 2 CHADS 2 score, in which renal dysfunction (eGFR<60mL/min per 1.73 m 2 using Cockroft-Gault formula) was assigned 2 points, but this was derived from anticoagulated clinical trial cohort, where the whole range of renal function was not studied (patients with eGFR<30 mL/min were excluded) and the broad range of stroke risk was not evident (the trial population excluded those with a CHADS 2 scores 0-1 and even CHADS 2 =2 was capped at 10%).…”

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…Choć na CKD wskazuje oszacowany klirens kreatyniny (CrCl) < 60 ml/min, to w wielu próbach klinicznych u pacjentów z AF modyfikowano dawkę NOAC, jeżeli CrCl (zwykle szacowany za pomocą wzoru Cockcrofta-Gaulta) wynosił < 50 ml/min. U pacjentów z AF z czasem CrCl może się zmniejszać [317]. Doustne leczenie przeciwzakrzepowe u pacjentów z CKD omówiono w rozdziale 8.2.4.…”