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Dec 08, 2014

Blood Thinner Benefits Patients with AFib and Advanced Kidney Disease

Warfarin helps reduce stroke risk in patients with atrial fibrillation and advanced kidney disease, finds study.

The blood thinner warfarin (brand: Coumadin, Jantoven) helps reduce stroke risk in patients with atrial fibrillation and advanced kidney disease, according to a study published in the Journal of the American College of Cardiology

Atrial fibrillation, often referred to as AFib, is the most common type of irregular heart rhythm, affecting more than 2 million Americans. Since AFib significantly increases risk for stroke, blood thinners are often used to prevent clots and reduce risk of this life-threatening condition. However, little is known about the safety and efficacy of blood thinners in patients with both AFib and advanced chronic kidney disease. Not only does chronic kidney disease further increase stroke risk, this condition increases risk for bleeding—a known complication associated with blood thinners. 

To assess the use of blood thinners in this high-risk population, researchers analyzed data from the national Danish health registry, which was first established in 1978. The registry includes all Danish hospital admissions, along with details on diagnoses and treatment.  

Between 1997 and 2011, researchers identified almost 13,000 patients with non-valvular AFib and chronic kidney failure, roughly 1% of who received treatment for end-stage kidney disease. Compared to AFib patients without kidney disease, patients with both AFib and chronic kidney disease had anywhere from 1.6 to 5.5 times greater risk of stroke, depending on the severity of their disease. Warfarin, however, helped significantly reduce risk of stroke and death in this high-risk population. 

Findings add to a growing body of evidence around the benefits of warfarin use in patients with AFib and advanced chronic kidney disease.  Not only does evidence highlight the increased stroke risk, particularly in patients with AFib and stage 5 kidney disease, it suggests that the benefits of warfarin use may outweigh risks associated with such treatment. However, it’s important that patients work with their doctor to understand risks and benefits associated with treatment in order to determine the best possible treatment.

Read the full study in the Journal of the American College of Cardiology

Questions for You to Consider

  • What is atrial fibrillation?

  • Atrial fibrillation is an irregular heart rhythm caused by abnormal, chaotic electrical impulses in the heart’s upper chambers, the atria. These electrical impulses, which interfere with the heart’s natural pacemaker, fire so rapidly the atria cannot beat with a regular rhythm or squeeze out blood effectively. Instead, they merely quiver while the ventricles, the heart’s lower chambers, beat rapidly.

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Featured Video

Dr. Kanny S. Grewal, FACC, presents at a Living with Atrial Fibrillation event in Columbus, Ohio in Oct. 2014.