uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Changes in Renal Function in Patients With Atrial Fibrillation An Analysis From the RE-LY Trial
Show others and affiliations
2015 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 65, no 23, 2481-2493 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND Vitamin K-dependent factors protect against vascular and renovascular calcification, and vitamin K antagonists may be associated with a decreased glomerular filtration rate (GFR). OBJECTIVES This study analyzed changes in GFR during long-term treatment with warfarin or dabigatran etexilate (DE) in patients enrolled in the RE-LY (Randomized Evaluation of Long Term Anticoagulation Therapy) trial. METHODS Of the 18,113 patients in the RE-LY study randomized to receive DE (110 mg or 150 mg twice daily) or warfarin, 16,490 patients with atrial fibrillation had creatinine values measured at baseline and at least 1 follow-up visit. Changes in GFR for up to 30 months were evaluated. RESULTS GFR declined in all treatment groups. After an average of 30 months, the mean +/- SE decline in GFR was significantly greater with warfarin (-3.68 +/- 0.24 ml/min) compared with DE 110 mg (-2.57 +/- 0.24 ml/min; p = 0.0009 vs. warfarin) and DE 150 mg (-2.46 +/- 0.23 ml/min; p = 0.0002 vs. warfarin). A decrease in GFR >25% was less likely with DE 110 mg (hazard ratio: 0.81 [95% confidence interval: 0.69 to 0.96]; p = 0.017) or DE 150 mg (hazard ratio: 0.79 [95% confidence interval: 0.68 to 0.93]; p = 0.0056) than with warfarin in the observation period >18 months. Patients with poor international normalized ratio control (i.e., time in therapeutic range <65%) exhibited a faster decline in GFR. A more pronounced decline in GFR was associated with previous warfarin use and with the presence of diabetes. CONCLUSIONS Patients with atrial fibrillation receiving oral anticoagulation exhibited a decline in renal function that was greater in those taking warfarin versus DE, and it was amplified by diabetes and previous vitamin K antagonist use.

Place, publisher, year, edition, pages
2015. Vol. 65, no 23, 2481-2493 p.
Keyword [en]
anticoagulation, atrial fibrillation, renal function, thrombin inhibition, vitamin K antagonist
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:uu:diva-256988DOI: 10.1016/j.jacc.2015.03.577ISI: 000356002800003PubMedID: 26065986OAI: oai:DiVA.org:uu-256988DiVA: diva2:836035
Available from: 2015-06-30 Created: 2015-06-29 Last updated: 2015-06-30Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Hijazi, ZiadWallentin, Lars
By organisation
UCR-Uppsala Clinical Research CenterCardiology
In the same journal
Journal of the American College of Cardiology
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 206 hits
ReferencesLink to record
Permanent link

Direct link