Ischaemic stroke, haemorrhage, and mortality in older patients with chronic kidney disease newly started on anticoagulation for atrial fibrillation: a population based study from UK primary care
Shankar, K; de Lusignan, S; McGovern, A; et al.Correa, A; Hriskova, M; Gatenby, P; Jones, S; Goldsmith, D; Camm, A John
Date: 14 February 2018
Journal
BMJ
Publisher
BMJ Publishing Group
Publisher DOI
Abstract
OBJECTIVE
To assess the association between anticoagulation,
ischaemic stroke, gastrointestinal and cerebral
haemorrhage, and all cause mortality in older people
with atrial fibrillation and chronic kidney disease.
DESIGN
Propensity matched, population based, retrospective
cohort analysis from January 2006 through December
20 ...
OBJECTIVE
To assess the association between anticoagulation,
ischaemic stroke, gastrointestinal and cerebral
haemorrhage, and all cause mortality in older people
with atrial fibrillation and chronic kidney disease.
DESIGN
Propensity matched, population based, retrospective
cohort analysis from January 2006 through December
2016.
SETTING
The Royal College of General Practitioners Research
and Surveillance Centre database population of
almost 2.73 million patients from 110 general
practices across England and Wales.
PARTICIPANTS
Patients aged 65 years and over with a new diagnosis
of atrial fibrillation and estimated glomerular filtration
rate (eGFR) of <50 mL/min/1.73m2
, calculated
using the chronic kidney disease epidemiology
collaboration creatinine equation. Patients with a
previous diagnosis of atrial fibrillation or receiving
anticoagulation in the preceding 120 days were
excluded, as were patients requiring dialysis and
recipients of renal transplants.
INTERVENTION
Receipt of an anticoagulant prescription within 60
days of atrial fibrillation diagnosis.
MAIN OUTCOME MEASURES
Ischaemic stroke, cerebral or gastrointestinal
haemorrhage, and all cause mortality.
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