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22대 대한민국 국회 국회정보길라잡이 국회의원검색
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Purpose: Advanced chronic kidney disease (CKD), including end-stage renal disease (ESRD) on dialysis, increases thromboembolic risk among patients with atrial fibrillation (AF). This study examined the comparative safety and efficacy of direct-acting oral anticoagulant (DOAC) compared to warfarin or no oral anticoagulant (OAC) in AF patients with advanced CKD or ESRD on dialysis.

Materials and Methods: Using data from the COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry, 260 non-valvular AF patients with advanced CKD (defined as estimated glomerular filtration rate ＜30 mL/min per 1.73/m2) or ESRD on dialysis were enrolled from June 2016 to July 2020. The study population was categorized into DOAC, warfarin, and no OAC groups; and differences in major or clinically relevant non-major (CRNM) bleeding, stroke/systemic embolism (SE), myocardial infarction/critical limb ischemia (CLI), and death were assessed.

Results: During a median 24 months of follow-up, major or CRNM bleeding risk was significantly reduced in the DOAC group compared to the warfarin group [hazard ratio (HR) 0.11, 95% confidence interval (CI) 0.01 to 0.93, p=0.043]. In addition, the risk of composite adverse clinical outcomes (major or CRNM bleeding, stroke/SE, myocardial infarction/CLI, and death) was significantly reduced in the DOAC group compared to the no OAC group (HR 0.16, 95% CI 0.03 to 0.91, p=0.039).

Conclusion: Among AF patients with advanced CKD or ESRD on dialysis, DOAC was associated with a lower risk of major or CRNM bleeding compared to warfarin and a lower risk of composite adverse clinical outcomes compared to no OAC.

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기사명 저자명 페이지 원문 목차
Mathematical modeling of COVID-19 transmission and intervention in South Korea : a review of literature Hyojung Lee, Sol Kim, Minyoung Jeong, Eunseo Choi, Hyeonjeong Ahn, Jeehyun Lee p. 1-10

Comparison of the 2022 ACR/EULAR classification criteria for antineutrophil cytoplasmic antibody-associated vasculitis with previous criteria Jung Yoon Pyo, Lucy Eunju Lee, Yong-Beom Park, Sang-Won Lee p. 11-17

Oral anticoagulation therapy in atrial fibrillation patients with advanced chronic kidney disease : CODE-AF registry Hanjin Park, Hee Tae Yu, Tae-Hoon Kim, Junbeom Park, Jin-Kyu Park, Ki-Woon Kang, Jaemin Shim, Jin-Bae Kim, Jun Kim, Eue-Keun Choi, Hyung Wook Park, Young Soo Lee, Boyoung Joung p. 18-24, [1-5]

Machine-learning model for the prediction of hypoxaemia during endoscopic retrograde cholangiopancreatography under monitored anaesthesia care Huapyong Kang, Bora Lee, Jung Hyun Jo, Hee Seung Lee, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Si Young Song, Joonhyung Park, Hajin Shim ... [et al.] p. 25-34, [1]

High mean platelet volume is associated with cerebral white matter hyperintensities in non-stroke individuals Jung-Won Choi, Kee Ook Lee, Ye-Ji Jang, Hyun-Kyung Kim, Taeho Seo, Yoo Jeong Roh, Seung-Ook Choo, Seung-Hun Oh p. 35-41

Changes in subjective outcomes during the early period after septoturbinoplasty Geun Cheol Shin, Ju Wan Kang, Ju Ha Park, Han Cheol Lee, Kyung-Su Kim p. 42-47

Interactions between sleep apnea and coronary artery disease on the incidence of sudden cardiac arrest : a multi-center case-control study Eujene Jung, Hyun Ho Ryu, Young Sun Ro, Kyoung Chul Cha, Sang Do Shin, Sung Oh Hwang p. 48-53

Association between electronic cigarettes use and asthma in the United States : data from the National Health Interview Survey 2016-2019 Seo Yoon Lee, Jaeyong Shin p. 54-65, [1-6]

SARS-CoV-2-infected pregnant woman requiring 38 days of extracorporeal membrane oxygenation experiences rectal ulcer bleeding : a case report Hanna Moon, Jung Mo Lee, Eui Hyeok Kim p. 66-70

Changes in expenditures of the National Health Insurance of Korea during the COVID-19 pandemic and the financial implications thereof Yoon Jung Choi, Jungwoo Sohn, Tae Hyun Kim p. 71-75

참고문헌 (29건) : 자료제공( 네이버학술정보 )

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번호 참고문헌 국회도서관 소장유무
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16 Chan KE, Edelman ER, Wenger JB, Thadhani RI, Maddux FW. Dabigatran and rivaroxaban use in atrial fibrillation patients on hemodialysis. Circulation 2015;131:972-9. 미소장
17 Padrini R. Clinical pharmacokinetics and pharmacodynamics of direct oral anticoagulants in patients with renal failure. Eur J Drug Metab Pharmacokinet 2019;44:1-12. 미소장
18 Chang M, Yu Z, Shenker A, Wang J, Pursley J, Byon W, et al. Effect of renal impairment on the pharmacokinetics, pharmacodynamics, and safety of apixaban. J Clin Pharmacol 2016;56:637-45. 미소장
19 Siontis KC, Zhang X, Eckard A, Bhave N, Schaubel DE, He K, et al. Outcomes associated with apixaban use in patients with end-stage kidney disease and atrial fibrillation in the United States. Circulation 2018;138:1519-29. 미소장
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21 Koretsune Y, Yamashita T, Kimura T, Fukuzawa M, Abe K, Yasaka M. Short-term safety and plasma concentrations of edoxaban in Japanese patients with non-valvular atrial fibrillation and severe renal impairment. Circ J 2015;79:1486-95. 미소장
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23 Hohnloser SH, Hijazi Z, Thomas L, Alexander JH, Amerena J, Hanna M, et al. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation:insights from the ARISTOTLE trial. Eur Heart J 2012;33:2821-30. 미소장
24 Bonde AN, Lip GY, Kamper AL, Hansen PR, Lamberts M, Hommel K, et al. Net clinical benefit of antithrombotic therapy in patients with atrial fibrillation and chronic kidney disease: a nationwide observational cohort study. J Am Coll Cardiol 2014;64:2471-82. 미소장
25 Chan KE, Lazarus JM, Thadhani R, Hakim RM. Warfarin use associates with increased risk for stroke in hemodialysis patients with atrial fibrillation. J Am Soc Nephrol 2009;20:2223-33. 미소장
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