A TYPICAL PATIENT WITH ATRIAL FIBRILLATION AND RENAL DYSFUNCTION - HOW TO PREVENT STROKE?
https://doi.org/10.15829/1560-4071-2015-5-134-138
Abstract
Aim. To evaluate efficacy and safety of rivaroxaban for stroke and systemic
embolism prevention in patients with AF of non-valvular cause and concomitant
CKD.
Material and methods. Totally 16 patients with AF included, having chronic kidney
disease of II-III stages, who during a year were being assessed an efficacy — cases
of death, stroke and systemic embolism, and drug safety (clinically significant and
non-significant bleedings).
Results. As a result for efficacy — stroke, systemic embolism, death cases were not
registered. In assessment of safety, mild nasal bleedings (not needed medical help)
were marked in 3 patients during one month of treatment, and in 2 patients there
were non-persistent petechias. Clinically significant bleedings were not registered.
Conclusion. The usage of the oral anticoagulant rivaroxaban in dose 20 mgand 15 mg per day in patients with AF of non-valvular cause with comorbid CKD II-III stage is effective and safe for the prevention of stroke and systemic embolism.
About the Authors
N. G. Lozhkina
SBEI HPE Novosibirsk State Medical University of the Healthcare Ministry, Novosibirsk, Russia
Russian Federation
Russian Federation
A. A. Abuzdina
SBEI HPE Novosibirsk State Medical University of the Healthcare Ministry, Novosibirsk, Russia
Russian Federation
Russian Federation
A. D. Kuimov
SBEI HPE Novosibirsk State Medical University of the Healthcare Ministry, Novosibirsk, Russia
Russian Federation
Russian Federation
References
1. Go AS, Mozaffarian D, Roger VL, etal. Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation. 2014; 129: e28-e292.
2. Wetmore JB, Mahnken JD, Rigler SK, et al. The prevalence of and factors associated with chronic atrial fibrillation in Medicare/Medicaid-eligible dialysis patients. Kidney Int. 2012; 81:469-76.
3. WinkelmayerWC, Patrick AR, Liu J, et al. The increasing prevalence of atrial fibrillation among hemodialysis patients. J Am Soc Nephrol. 2011; 22: 349-57.
4. Ananthapanyasut W, Napan S, Rudolph EH, et al. Prevalence of atrial fibrillation and its predictors in nondialysis patients with chronic kidney disease. Clin J Am Soc Nephrol. 2010; 5:173-81.
5. NishaBansal, Dongjie Fun, Chi-yuan Hsu, etal. Incident Atrial Fibrillation and Risk of Death in Adults With Chronic Kidney Disease. J Am Heart Assoc. 2014; 3(5): e001303.
6. O'Neal WT, Tanner RM, Efird JT, et al. Atrial fibrillation and incident end-stage renal disease: The REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Int J Cardiol. 2015; 12; 185:219-23.
7. Moiseev ВС, Muhin NA, Kobalava ZhD, et al. National guidelines. Cardiovascular risk and chronic kidney disease: strategies cardio nephroprotection. Russian Journal of Cardiology 2014, 8 (112): 7-37. Russian (Моисеев B.C., Мухин Н.А. КобалаваЖ.Д. и др. Национальные рекомендации. Сердечно-сосудистый риск и хроническая болезнь почек: стратегии кардио-нефропротекции. Российский кардиологический журнал 2014, 8 (112): 7-37).
8. Shutov AM, Serov VA, Kurzina EV, et al. Chronic kidney disease and atrial fibrillation in patients with chronic heart failure. Ter. arh 2009; 12: 23-6. Russian (Шутов A.M., Серов В.А., Курзина Е. В. и др. Хроническая болезнь почек и фибрилляция предсердий у больных с хронической сердечной недостаточностью. Тер. арх. 2009; 12:23-6).
9. Camm AG, Lip GYH, de Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur. Heart. J. 2012; 33: 2719-47.
10. National guidelines for diagnosis and treatment of atrial fibrillation (2012). Russian Journal of Cardiology 2013, 4: 1-100. Suppl. 3 Russian (Национальные рекомендации по диагностике и лечению фибрилляции предсердий, 2012, Российский кардиологический журнал 2013,4: 1-100. Приложение 3).
11. Gu J, Jia F, Feng P. CHADS2 versus CHA2DS2-VASC scoring systems for predicting left atrial thrombus in patients with nonvalvular atrial fibrillation. Nan Fang Yi Ke Da Xue Xue Bao. 2014; 34:1601-5.
12. Pisters R, Lane DA, Nieuwlaat R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey Chest. 2010; 138:1093-100.
13. Steinberg BA, Hellkamp AS , LokhnyginaY, et al. Higher risk of death and stroke in patients with persistent vs. paroxysmal atrial fibrillation: results from the ROCKET-AF Trial Eur. Heart. J. 2014; Sep. 10.
14. Harel Z, Sood MM, Perl J. Comparison of novel oral anticoagulants versus vitamin К antagonists in patients with chronic kidney disease. Curr Opin Nephrol Hypertens. 2015; 24: 183-92.
15. Fox KAA, Piccini JP, Wojdyla D, et al. Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and moderate renal impairment. European Heart Journal (2011) 32, 2387-94.
Review
For citations:
Lozhkina N.G., Abuzdina A.A., Kuimov A.D. A TYPICAL PATIENT WITH ATRIAL FIBRILLATION AND RENAL DYSFUNCTION - HOW TO PREVENT STROKE? Russian Journal of Cardiology. 2015;(5):134-138. (In Russ.) https://doi.org/10.15829/1560-4071-2015-5-134-138
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