Background: Dose reduction of non–vitamin K antagonist oral anticoagulants (NOACs) is
indicated in patients with atrial fibrillation (AF) with renal impairment. Failure to reduce the
dose in patients with severe kidney disease may increase bleeding risk, whereas dose
reductions without a firm indication may decrease the effectiveness of stroke prevention.
Objectives: The goal of this study was to investigate NOAC dosing patterns and associated
outcomes, ie, stroke (ischemic stroke and systemic embolism) and major bleeding in …

Atrial fibrillation (AF) is the commonest cardiac arrhythmia and is an independent risk factor
for stroke and mortality. Oral anticoagulation is the cornerstone of management for primary
and secondary stroke prophylaxis in patients with AF and known additional risk factors (1).
Whilst oral vitamin K antagonists (VKA) such as warfarin were the mainstay of treatment for
decades, they have been superseded by the newer non-vitamin K antagonist oral
anticoagulants (NOACs), which offer relative efficacy, safety and convenience compared to …