Warfarin in CKD Linked to Lower CVD Risk
Lower risk with no increase in bleeding regardless of CKD severity.
For patients with established cardiovascular disease and atrial fibrillation, warfarin treatment correlates with a lower risk of a composite of death, myocardial infarction (MI), and ischemic stroke, with no increased risk of bleeding, regardless of chronic kidney disease (CKD) severity, according to a study published in the Journal of the American Medical Association.
Juan Jesús Carrero, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues examined outcomes associated with warfarin treatment in relation to kidney function in a cohort of 24,317 MI survivors with atrial fibrillation and known serum creatinine. Of these, 21.8 percent were prescribed warfarin at discharge. The estimated glomerular filtration rate was used to classify stage of CKD among the 51.7 percent of patients with manifest CKD.
The researchers found that warfarin use was associated with a reduced risk of the composite outcome of death, readmission for MI, or ischemic stroke compared with no warfarin use in each CKD stratum. Warfarin-treated patients did not have a significantly increased risk of bleeding events in any CKD stratum. In each CKD stratum, warfarin use correlated with reduced risk of the aggregate outcome (aggregate of composite end point and bleeding).
"Warfarin treatment was associated with a lower one-year risk for the composite outcome of death, MI, and ischemic stroke without a higher risk of bleeding," the authors write. "This association was not related to the severity of concurrent CKD."
Several authors disclosed financial ties to the pharmaceutical industry.