Patients with atrial fibrillation and concomitant renal insufficiency are at an increased risk of thromboembolic and bleeding complications. Oral factor Xa inhibitor apixaban, which has a low degree of renal excretion is therefore an attractive therapeutic option for this population.
The predefined secondary analysis of patients with kidney disease in a study ARISTOTLE apixaban was superior to warfarin in preventing stroke, systemic embolism, total mortality and major bleeding regardless of the degree of renal impairment.