Atrial Fibrillation, Chronic Kidney Disease, Elderly Patients
Conditions
Keywords
direct oral anticoagulants, atrial fibrillation, renal function, ckd-epi, plasmatic concentration
Brief summary
Atrial fibrillation in the elderly is a complex condition due to the high number of frequently associated comorbidities such kidney disease. Direct oral anticoagulants (dabigatran, rivaroxaban and apixaban) are indicated for preventing thromboembolic events but renal function should be closely monitored for this age group when these drugs are used. Dosing recommendations for prevention of stroke are based on renal clearance of creatinine (ClCr) estimated using the Cockcroft-Gault formula. It is well known that ClCr estimates predict a steeper decline with advancing age than Glomerular Filtration Rate (GFR) estimates. This raises the possibility that substitution of commonly reported GFR for estimated CrCl could result in different plasmatic concentrations of oral direct anticoagulants. The aim of this study was to compare estimates of ClCr and GFR and determine the impact on the plasmatic concentration of these drugs in elderly patients with non-valvular atrial fibrillation.
Interventions
OTHERBlood sample
2 additional tubes of blood samples are collected during a blood sample realized for the patient's care
Sponsors
University Hospital, Montpellier
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
Patients with non-valvular atrial fibrillation -treated with dabigatran, rivaroxaban or apixaban - patients affiliated to national social health system -patients who agreed to ethical concerns of the study
Exclusion criteria
Patients with consultation or hospitalization that made impossible a veinous punction at the steady state residual concentration time -Patients under guardianship or trusteeship
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| renal function estimated by different glomerular filtration rate equations and by clearance of creatinine formula | At the inclusion |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| plasmatic activity of direct oral anticoagulant at steady state residual time (anti-Xa or anti-IIa) | At the inclusion | — |
| plasmatic concentration of direct oral anticoagulant at steady state residual time | At the inclusion | — |
| Number of haemorrhagic or thrombotic adverse events (serious or not) affecting patients | At 1 month | Reported by a trained physician after a phone interview with the patient coupled with medication adherence assessment using 6-item Moriksy scale. An internal questionnaire will be used to collect data. |
| Number of haemorrhagic or thrombotic adverse events (serious or not) and unexpected events affecting patients | At 6 months | Reported by a trained physician after a phone interview with the general practitioner and the patient coupled with medication adherence assessment using 6-item Moriksy scale. An internal questionnaire will be used to collect data. |
Countries
France
Outcome results
None listed