Direct Oral Anticoagulants Versus Warfarin Across the Spectrum of Kidney Function: Patient-Level Network Meta-Analyses From COMBINE AF.
Josephine HarringtonAnthony P CarnicelliKaiyuan HuaLars WallentinManesh R PatelStefan H HohnloserRobert P GiuglianoKeith A A FoxZiad HijaziRenato Deláscio LopesSean D PokorneyHwanhee HongChristopher B GrangerPublished in: Circulation (2023)
Standard-dose DOACs are safer and more effective than warfarin down to a CrCl of at least 25 mL/min. Lower-dose DOACs do not significantly lower the incidence of bleeding or ICH compared with standard-dose DOACs but are associated with a higher incidence of S/SE and death. These findings support the use of standard-dose DOACs over warfarin in patients with kidney dysfunction.