Abstract:
UNASSIGNED: Patients with atrial fibrillation (AF) are routinely prescribed oral anticoagulants to prevent thromboembolism. Concerns regarding the efficacy and safety of oral anticoagulants, such as vitamin K antagonists (VKA) and direct oral anticoagulants (DOACs), arise for patients with non-valvular atrial fibrillation (NVAF) because of their widespread use in clinical practice. Even though there have been an abundance of studies on this topic, it is still not clear if DOAC users with NVAF have a lower risk of acute kidney injury (AKI) than warfarin users.
UNASSIGNED: We conducted electronic searches in PubMed, Embase, and the Cochrane Library to identify relevant studies for this systematic review. We included randomized clinical trials and observational studies that reported on the incidence rate, hazard ratio (HR), and 95% confidence interval (95% CI) of AKI in patients using oral anticoagulants. This systemic review included six observational studies and four randomized clinical trials (RCT). The overall results showed that DOACs were associated with a lower AKI risk than warfarin. However, for NVAF patients with severe renal dysfunction, DOACs may not have a reduced risk of AKI compared to warfarin.
UNASSIGNED: The overall results suggest that, except for edoxaban, patients using DOACs may experience a reduced risk of AKI. However, it is uncertain whether this is also the case for patients with severe renal dysfunction. Further research is needed to confirm the effect of DOACs on this population.
摘要:
未经证实:房颤(AF)患者常规使用口服抗凝剂预防血栓栓塞。关于口服抗凝剂的疗效和安全性的担忧,如维生素K拮抗剂(VKA)和直接口服抗凝剂(DOAC),非瓣膜性心房颤动(NVAF)患者因其在临床实践中的广泛使用而出现。尽管有大量关于这个主题的研究,目前尚不清楚服用NVAF的DOAC患者发生急性肾损伤(AKI)的风险是否低于华法林患者.
UNASSIGNED:我们在PubMed进行了电子搜索,Embase,和Cochrane图书馆为本次系统评价确定相关研究。我们纳入了随机临床试验和观察性研究,报告了发病率,危险比(HR),使用口服抗凝剂的患者的AKI和95%置信区间(95%CI)。该系统综述包括6项观察性研究和4项随机临床试验(RCT)。总体结果表明,DOACs的AKI风险低于华法林。然而,对于严重肾功能不全的NVAF患者,与华法林相比,DOAC可能不会降低AKI的风险。
未经评估:总体结果表明,除了edoxaban,使用DOAC的患者发生AKI的风险可能降低.然而,对于严重肾功能不全的患者是否也是如此,尚不确定。需要进一步的研究来证实DOAC对该人群的影响。