Advances of safety of antithrombotic therapy in patients with chronic kidney disease plus atrial fibrillation after percutaneous coronary intervention

Abstract

Patients of atrial fibrillation （AF） are prone to develop secondary coronary artery disease （CAD） and acute coronary syndrome （ACS） or percutaneous coronary intervention （PCI） is required. Anticoagulation and antiplatelet therapy are a gold standard for AF patients with post-PCI. However, there is a great risk of hemorrhage. Renal function affects the occurrence of hemorrhagic events and then shifts a balance of advantages and disadvantages of antithrombotic therapy. The safety of antithrombotic therapy was explored in patients with chronic kidney disease （CKD） complicated with AF post-PCI. The databases of PubMed, Cochrane and EMBASE were searched for cohort research studies of CKD plus AF patients on antithrombotic therapy post-PCI. As compared with those taking vitamin K antagonists, users of direct oral anticoagulants （DOAC） had fewer hemorrhagic events. For CKD plus AF patients post-PCI, the safety of DOAC was higher than those taking vitamin K antagonists. For patients with eGFR ＞30 mL·min−1·（1.73 m2）−1, the progression of CKD had no significant impact on the safety of DOAC.

Keywords

• chronic kidney disease
• atrial fibrillation
• percutaneous coronary intervention