{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:10:20Z","timestamp":1787062220394,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T00:00:00Z","timestamp":1708732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Patients with severely reduced kidney function have been excluded from randomized controlled trials and data on the safety and efficacy of direct oral anticoagulants (DOACs) according to kidney function remain sparse. The aim was to evaluate the safety and efficacy of the DOACs across subgroups of kidney function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using multiple Danish nationwide registers and laboratory databases, we included patients initiated on oral anticoagulants (OACs) with atrial fibrillation and available creatinine level and followed patients for 2 years to evaluate occurrence of stroke\/thromboembolism (TE) and major bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 26\u2009686 included patients, 3667 (13.7%) had an estimated glomerular filtration rate (eGFR) of 30\u201349\u00a0mL\/min\/1.73\u00a0m2 and 596 (2.2%) had an eGFR below 30 mL\/min\/1.73\u00a0m2. We found no evidence of differences regarding the risk of stroke\/TE between the OACs (P-value interaction &amp;gt;0.05 for all). Apixaban was associated with a lower 2-year risk of major bleeding compared to vitamin K antagonists (VKA) [hazard ratio 0.79, 95% confidence interval (CI) 0.67\u20130.93], and the risk difference was significantly larger among patients with reduced kidney function (P-value interaction 0.018). Rivaroxaban was associated with a higher risk of bleeding compared to apixaban (hazard ratio 1.78, 95%CI 1.32\u20132.39) among patients with eGFR 30\u201349\u00a0mL\/min\/1.73\u00a0m2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, we found no differences regarding the risk of stroke\/TE, but apixaban was associated with a 21% lower relative risk of major bleeding compared to VKA. This risk reduction was even greater when comparing apixaban to VKA among patients with eGFR 15\u201330\u00a0mL\/min\/1.73\u00a0m2, and when comparing apixaban to dabigatran and rivaroxaban among patients with eGFR 30\u201349\u00a0mL\/min\/1.73\u00a0m2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvae016","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T08:53:01Z","timestamp":1708678381000},"page":"210-218","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy and safety of oral anticoagulants according to kidney function among patients with atrial fibrillation"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2220-0375","authenticated-orcid":false,"given":"Casper","family":"Binding","sequence":"first","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte , 2900 Hellerup , Denmark"},{"name":"Department of Cardiology, Aalborg Universitetshospital , Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1415-7976","authenticated-orcid":false,"given":"Paul","family":"Blanche","sequence":"additional","affiliation":[{"name":"Department of Public Health, Section of Biostatistics, University of Copenhagen , 1014 Copenhagen K , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool , UK"},{"name":"Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University , Aalborg , 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Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0548-402X","authenticated-orcid":false,"given":"Gunnar","family":"Gislason","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte , 2900 Hellerup , Denmark"},{"name":"Department of Cardiovascular Epidemiology and Research, The Danish Heart Foundation , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-6131","authenticated-orcid":false,"given":"Christian","family":"Torp-Pedersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte , 2900 Hellerup , Denmark"},{"name":"Department of Cardiology, Nordsj\u00e6llands Hospital , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas 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