Internal and Emergency Medicine

, Volume 13, Issue 7, pp 1001–1004 | Cite as

Estimating renal function in patients with atrial fibrillation: which dose of direct oral anticoagulants?

  • Nicoletta Riva
  • Walter Ageno
  • Alex Gatt

Atrial fibrillation (AF) is the most common cardiac dysrhythmia, affecting more than eight million people in the European Union [1]. AF is associated with a fivefold increased risk of ischemic stroke and is also an independent risk factor for stroke severity and mortality [1]. Renal impairment is common among AF patients, with a reported prevalence of mild renal impairment in 47% of patients and moderate–severe renal impairment in 18% of patients in a European registry [2]. AF patients with renal impairment are at increased risk of bleeding, stroke or systemic embolism, myocardial infarction and all-cause mortality, as compared to AF patients with normal renal function [3].

The 2016 European Society of Cardiology guidelines suggest the direct oral anticoagulants (DOACs) as the first choice anticoagulant treatment for AF patients [4]. However, all the currently available DOACs are at least partially renally excreted [5], therefore requiring an estimate of renal function before the...


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The Authors declare that they  have no conflict of interest.

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Copyright information

© SIMI 2018

Authors and Affiliations

  1. 1.Department of Pathology, Faculty of Medicine and SurgeryUniversity of MaltaMsidaMalta
  2. 2.Department of Medicine and SurgeryUniversity of InsubriaVareseItaly

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