Abstract
Atrial fibrillation is a major burden on global healthcare systems, with an estimated 60 million patients affected by atrial fibrillation in 2019.1 Besides stroke, comorbidities and systemic complications related to atrial fibrillation, including kidney damage, are receiving increasing attention, and this issue has been addressed in several clinical guidelines.2–4 Atrial fibrillation is associated with the risk of kidney damage through several mechanisms, including the formation of micro-thrombi causing ischemic injury to the kidneys.5–7 Additionally, in patients using vitamin K antagonists, kidney damage may progress more rapidly due to the direct damaging effect on the kidneys.8
Rivaroxaban is one of the commonly used options in patients with severe renal impairment, and there is some evidence from real-world data showing its positive impact on kidney function.9 However, evidence on renal outcomes of rivaroxaban has only been at the level of individual real-world studies, and there has not been a comprehensive analysis evaluating this issue. Therefore, a group of Vietnamese experts conducted a systematic review and meta-analysis - "Evaluating Renal Benefits of Rivaroxaban versus Vitamin K Antagonist in Atrial Fibrillation: A Systematic Review and Meta-analysis of Real-World Evidence" (RESTORE) with the aim of comparing the effects of rivaroxaban and vitamin K antagonists on renal outcomes. Important information from the RESTORE analysis, which was recently presented at the Annual Conference of the American College of Cardiology, will be summarized in the content below.