Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Secondary stroke prophylaxis in atrial fibrillation patients with chronic kidney disease: a nationwide cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. C-reactive protein after coronary artery bypass graft surgery and its relationship with postoperative atrial fibrillation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Defibrillators for prevention from sudden cardiac death: is it that easy?-Authors' reply

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Incidence of acute myocardial infarction-related cardiogenic shock during corona virus disease 19 (COVID-19) pandemic

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Hypertension, cardiovascular disease and cause of death in Danish living kidney donors: matched cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Recurrent infective endocarditis versus first-time infective endocarditis after heart valve surgery

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Time trends in incidence, comorbidity, and mortality of ischemic stroke in Denmark, 1996-2016

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Mathias Aagaard Christensen
  • Emil Loldrup Fosbøl
  • Anders Nissen Bonde
  • Jonas Bjerring Olesen
  • Gunnar H Gislason
  • Christian Torp-Pedersen
  • Anna Gundlund
Vis graf over relationer

AIMS: Oral anticoagulation (OAC) therapy as secondary stroke prophylaxis in atrial fibrillation (AF) patients with chronic kidney disease (CKD) remains unexplored and poses a clinical treatment dilemma. We assessed the long-term risk of thromboembolic events according to post-stroke OAC therapy in AF patients with CKD after their first ischaemic stroke.

METHODS AND RESULTS: We identified Danish AF patients with CKD who presented with first-time ischaemic stroke from 2005 to 2014. Chronic kidney disease was defined as a diagnosis code for CKD before baseline, defined as 100 days after stroke discharge. Post-stroke antithrombotic therapy (OAC therapy and antiplatelet therapy) was identified from prescription claims from discharge to baseline. Cumulative incidences and adjusted hazard ratios (HRs) of thromboembolic events according to post-stroke OAC therapy were examined. Of 1252 AF patients with CKD presenting with ischaemic stroke, 631 (50.4%) patients were on OAC therapy and 621 (49.6%) were on antiplatelet therapy alone at baseline [median age 76 (interquartile range, IQR 71-83) and 80 (IQR 72-86), respectively]. The median follow-up period was 1.9 years (IQR 0.8-3.6). Cumulative incidence rates of thromboembolic events and bleeding showed no significant difference between those on OAC therapy and antiplatelet therapy. The results from the multivariable analysis revealed similar results: thromboembolic risk was not modified by OAC treatment [adjusted HR 0.89, 95% confidence interval (CI) 0.73-1.09] nor was the risk of bleeding (adjusted HR 0.88, 95% CI 0.67-1.17).

CONCLUSION: Oral anticoagulation in patients with CKD and prior stroke was not associated with a reduced risk of recurrent thromboembolic events compared with antiplatelet therapy.

OriginalsprogEngelsk
TidsskriftEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
Vol/bind22
Udgave nummer5
Sider (fra-til)716-723
Antal sider8
ISSN1099-5129
DOI
StatusUdgivet - 1 maj 2020

Bibliografisk note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.

ID: 58719291