Patients with chronic kidney disease are at a higher risk of cardiovascular diseases, like atrial fibrillation. However, the risk of other CVD events, like ischemic stroke, hemorrhage, and mortality is unknown. This study aims to examine the risk of cardiovascular events, like anticoagulation, ischaemic stroke, and cerebral hemorrhage in older patients with chronic kidney disease.

This is a population-based, propensity-matched, retrospective cohort analysis that included a total of 6,977 patients aged 65 years and above with chronic kidney disease and newly diagnosed atrial fibrillation. 2,434 participants were on anticoagulants within 60 days of diagnosis. The primary outcome of the study was the incidence of a CVD event, including ischemic stroke, cerebral hemorrhage, and all-cause mortality.

The findings suggested that the crude rates for ischemic stroke and hemorrhage were 4.6 and 1.2 per 100 person-years, respectively, after taking coagulants; and 1.5 and 0.4 in patients who were not taking anticoagulants. The hazard ratios for hemorrhage, ischemic stroke, and all-cause mortality were 2.60, 2.42, and 0.82, respectively, when compared with those who did not receive anticoagulation.

The research concluded that the use of anticoagulants in older patients with chronic kidney disease and arterial fibrillation was associated with an increased rate of ischemic stroke and hemorrhage, but not with all-cause mortality.

Ref: https://www.bmj.com/content/360/bmj.k342