{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:54:09Z","timestamp":1787586849474,"version":"build-2736575974"},"reference-count":29,"publisher":"SAGE Publications","issue":"2-3","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Asian Cardiovasc Thorac Ann"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Direct oral anticoagulants (DOACs) have been linked to better renal outcomes than warfarin in non-valvular atrial fibrillation (NVAF). We aimed to compare the renal function outcomes in Asian NVAF patients treated with warfarin and DOAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre retrospective study analysed NVAF patients newly initiated on oral anticoagulant (OAC) from 2013 to 2022 across seven tertiary hospitals. Using propensity-score matching, warfarin and DOAC recipients were matched by incorporating 22 variables potentially affecting renal outcomes. Primary endpoints include clinically significant (\u226530%) estimated glomerular filtration rate (eGFR) decline and worsened chronic kidney disease (CKD) stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 766 subjects (383 warfarin; 383 DOAC; mean age 70.7\u2009\u00b1\u20099.6 years) were analysed. Baseline eGFR was 75.0 (59.0\u201389.0) for warfarin and 76.0 (59.0\u201388.0) ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      for DOAC groups. Following median OAC treatment of 2.8\u2009\u00b1\u20091.6 years, 14.5% experienced clinically significant eGFR decline and 31.9% had worsened CKD stage. DOAC was associated with a lower risk of clinically significant eGFR decline (OR 0.529, 95% CI 0.343\u20130.817,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and worsened CKD stage (OR 0.713, 95% CI 0.521\u20130.975,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). In subgroup analysis, rivaroxaban (OR 0.337, 95% CI 0.157\u20130.724,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and dabigatran (OR 0.516, 95% CI 0.285\u20130.934,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029), but not apixaban (OR 0.759, 95% CI 0.432\u20131.333,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.338), were associated with a lower risk of clinically significant eGFR decline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant renal function decline is common during follow-up of Asian NVAF patients on OAC. Among the DOACs, rivaroxaban and dabigatran, but not apixaban, were associated with a lower risk of renal function decline than warfarin. These findings warrant confirmation in prospective randomised studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02184923251347471","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T03:09:42Z","timestamp":1748833782000},"page":"124-134","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Renal outcomes following oral anticoagulation in non-valvular atrial fibrillation: A multicentre, propensity-matched retrospective analysis in an Asian population"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2676-7755","authenticated-orcid":false,"given":"Hock Peng","family":"Koh","sequence":"first","affiliation":[{"name":"Pharmacy Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jivanraj","family":"R Nagarajah","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaa Yinn","family":"Tang","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szu Lynn","family":"Tay","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahimi","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Sultan Idris Shah, Ministry of Health Malaysia, Kajang, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li Ling","family":"Loh","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Sultan Idris Shah, Ministry of Health Malaysia, Kajang, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelfi Zhi Fei","family":"Chua","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Sarawak Heart Centre, Ministry of Health Malaysia, Kota Samarahan, Sarawak, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shantini","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Tuanku Ja'afar, Ministry of Health Malaysia, Seremban, Negeri Sembilan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep Kumar Nair","family":"Arumugam","sequence":"additional","affiliation":[{"name":"Medical Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.09.1087"},{"key":"e_1_3_4_3_2","first-page":"100844","article-title":"The change of renal functions after nonvitamin K oral anticoagulants in patients with atrial fibrillation","volume":"35","author":"Chantrarat T","year":"2021","unstructured":"Chantrarat T, Hauythan S. 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