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TUESDAY, Feb. 20, 2018 (HealthDay News) — For older patients with concomitant chronic kidney disease and a new diagnosis of atrial fibrillation, anticoagulants are associated with increased risk of ischemic stroke and hemorrhage, but with reduced risk of all-cause mortality, according to a study published online Feb. 14 in The BMJ<\/i>.<\/p>\n
Shankar Kumar, M.B.B.S., from University College London, and colleagues conducted a propensity-matched population-based cohort analysis from January 2006 through December 2016. Participants were aged 65 years and older with a new diagnosis of atrial fibrillation and estimated glomerular filtration rate of <50 mL\/min\/1.73 m\u00b2. Using propensity-score matching, 2,434 pairs of patients who were and were not on anticoagulants within 60 days of diagnosis were included.<\/p>\n
The researchers found that the crude rates for ischemic stroke and hemorrhage were 4.6 and 1.2 per 100 person-years after taking anticoagulants and 1.5 and 0.4 in patients not taking anticoagulants. Compared to those who received no anticoagulation, the hazard ratios for ischemic stroke, hemorrhage, and all-cause mortality were 2.60, 2.42, and 0.82, respectively, for those on anticoagulants.<\/p>\n
“Giving anticoagulants to older people with concomitant atrial fibrillation and chronic kidney disease was associated with an increased rate of ischemic stroke and hemorrhage but a paradoxical lowered rate of all-cause mortality,” the authors write. “Careful consideration should be given before starting anticoagulants in older people with chronic kidney disease who develop atrial fibrillation.”<\/p>\n