Net Benefit of Antithrombotic Therapy in AF and CKD
We have found that among AF patients, CKD was associated with a higher risk of stroke/TE across stroke risk (CHA2DS2-VASc) strata, most notably among RRT patients. In RRT patients with CHA2DS2-VASc score ≥2, warfarin was associated with a net clinical benefit, as it was associated with a lower risk of all-cause mortality. In non-end-stage CKD patients with CHA2DS2-VASc score ≥2, warfarin was associated with a net clinical benefit, as it was associated with a lower risk of all-cause mortality, a lower risk of cardiovascular death, and a lower risk of the composite outcome of fatal stroke/fatal bleeding, respectively. These observations provide guidance for the optimal use of antithrombotic therapy in AF patients with CKD.
Conclusions
We have found that among AF patients, CKD was associated with a higher risk of stroke/TE across stroke risk (CHA2DS2-VASc) strata, most notably among RRT patients. In RRT patients with CHA2DS2-VASc score ≥2, warfarin was associated with a net clinical benefit, as it was associated with a lower risk of all-cause mortality. In non-end-stage CKD patients with CHA2DS2-VASc score ≥2, warfarin was associated with a net clinical benefit, as it was associated with a lower risk of all-cause mortality, a lower risk of cardiovascular death, and a lower risk of the composite outcome of fatal stroke/fatal bleeding, respectively. These observations provide guidance for the optimal use of antithrombotic therapy in AF patients with CKD.