Evaluation of Renal Function in Patients with Atrial Fibrillation who Received Warfarin Compared with Aspirin
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Abstract
BACKGROUND: Aspirin is a drug commonly chosen to prevent strokes in patients with atrial fibrillation (AF) and those who are unable to receive warfarin, which the drug of choice. In the past, reports showed that both drugs had side effects on kidney function, but there have been no studies comparing the effects on kidney function in patients taking these drugs.
OBJECTIVE: This study aimed to evaluate kidney function in a group of patients with AF who received aspirin compared with a group that received warfarin.
METHODS: This retrospective study examined 360 AF patients treated at Phrapokklao Hospital, who were divided into 2 groups comprising 1 group of 24 patients who received aspirin and another group of 336 patients who received warfarin. To assess the renal function of the patients during a 1-year period of receiving the drug, the glomerular filtration rate (GFR) utilizing the dependent t-test and independent t-test were used, while various factors were analyzed using logistic regression.
RESULTS: In a 1-year period, the mean GFR of the patients in the warfarin group increased by 3.9 ml/min/1.73m² (95%CI 2.87-4.96) compared to the aspirin group, which decreased by 8.0 ml/min/1.73m² (95%CI (-10.30)-(-5.72)). The percentage change in GFR of the warfarin group increased by 11.9% (95%CI 7.98-15.87) more than the aspirin group (p<0.001). When using logistic regression for univariate analysis and multivariate analysis, it was found that the aspirin group had a 10% chance of a decrease in GFR compared to patients receiving warfarin with a crude odds ratio=14.33, p<0.001, 95%CI 5.84-35.16 and adjusted odds ratio=149.9, p=0.003, 95%CI 5.70-3,940.05.
CONCLUSION: In a 1-year period, AF patients who received aspirin were 10 percent or more likely to experience deterioration in kidney function compared with patients who received warfarin.
Thaiclinicaltrials.org number, TCTR20240509001
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