Warfarin in Patients with Atrial Fibrillation and Chronic Kidney Disease

Atrial fibrillation (AF) requiring anticoagulation frequently coexists with chronic kidney disease (CKD), raising concerns about increased risk for bleeding with warfarin therapy. In this analysis, investigators used data from a large Swedish registry to identify 24,317 consecutive survivors of myocardial infarction (MI) with AF and recorded creatinine levels. Of these, 22% were treated with warfarin at discharge, and 52% had abnormal kidney function (estimated glomerular filtration rate [eGFR], <60mL/min/1.73 m²).

At 1 year after discharge, risk for a composite endpoint of death, readmission for MI, or ischemic stroke was lower in warfarin recipients than in nonrecipients in every stratum of kidney dysfunction. In patients with an eGFR ≤15m…