For Atrial Fibrillation, DOACs Outperform Warfarin in Patients with Reduced Kidney Function.

Powell, Robert A; Coulter, Jessica S; Hoffman, Ariel L · J Am Board Fam Med · 2025

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Abstract

At standard doses, direct oral anticoagulants (DOACs) were associated with a reduced risk of systemic embolism and intracranial hemorrhage (ICH) when compared with warfarin, with a greater derived benefit at lower creatinine clearance (CrCl-down to 25 mL/min). Lower doses of DOACs were associated with increased overall mortality without a significant decrease in ICH and incident bleeding when compared with standard dose DOACs and warfarin, across all CrCl down to 25 mL/min.<sup>1</sup>.

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