Abstract 16914: On-treatment Outcomes in Patients With Worsening Renal Function With Rivaroxaban Compared With Warfarin: Insights From ROCKET AF

Introduction: ROCKET AF demonstrated the noninferiority of rivaroxaban vs. warfarin in preventing stroke and systemic embolism (SE) in patients with nonvalvular atrial fibrillation (AF). It is unknown whether outcomes differ among patients with worsening renal function (WRF) on rivaroxaban compared with warfarin. Methods: After excluding patients with insufficient data to calculate creatinine clearance (CrCl, Cockcroft-Gault; n=1624), we included all remaining patients (n=12,612) randomly assigned to either rivaroxaban or dose-adjusted warfarin. The primary efficacy endpoint was the composite of stroke or SE; the primary safety endpoint was the composite of major bleeding and clinically relevant non-major bleeding. On-treatment WRF, as defined in recent cardiovascular studies as a decrease of ≥20% from screening CrCl, was evaluated as a time-dependent covariate in Cox proportional hazards models. Results: Baseline characteristics were generally similar between patients who maintained stable renal function...