RE-ELECT. Dabigatran vs Warfarin in AF Patients With T2DM and CKD

• Status: Recruiting
• Trial end date: 2022-05-01
• Target enrollment: 0
• Participant gender: All

Summary

Kidney function in patients with atrial fibrillation (AF) is tending to decline over a time which is clearly demonstrated in clinical studies. Renal impairment is a risk factor for stroke, its progression is associated with unfavorable prognosis. So preserving kidney function should be considered as a one of priorities when choosing treatment strategies which is especially important in patients with existing chronic kidney disease (CKD) or in patients who have risk of its development. This is especially relevant for the patients with type 2 diabetes mellitus (T2DM) and with CKD who can be considered as a group of risk for rapid kidney function decline.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Irina Ermolaeva
• Treatments: Dabigatran; Warfarin

Criteria

Inclusion Criteria:

• Non-valvular atrial fibrillation

• Diagnosis of T2D according to Russian Clinical Guidelines

• Chronic kidney disease according to KDIGO definition*

• Stable RAS background treatment

• Age > 18 yrs;

• Informed consent to participate in the study signed by the patient.

Exclusion Criteria:

• HbA1c >10%

• UACR > 3000

• Renal transplant

• Biopsy proven kidney entities other than Diabetic Kidney Disease (if known only, no kidney biopsy is planned within the study)

• Background immunosuppressant therapy

• Hematologic disorders which can influence hemostasis (hemoblastosis, etc.); connective tissue diseases (SLE, systemic scleroderma, dermatomyositis) and any vasculitis;

• Primary or secondary antiphospholipid syndrome;

• Known cancer diagnosis;

• Major surgical interventions within 3 months before the study enrollment and planned for the timelines of the study;

• Clinically relevant bleeding events within 3 months before the study enrollment;

• Acute coronary syndrome, PCI or CABG within 12 months before the study enrollment;

• Hemorrhagic stroke within 12 months before the study enrollment;

• Organ damages resulted from clinically relevant bleeding within 6 months before randomization

• Major trauma or any craniocerebral trauma within 30 days before randomization

• Uncontrolled hypertension (systolic BP>180 and or diastolic BP>100 while on antihypertensive treatment)

• CHF III-IV functional class (by NYHA)

• Ischemic stroke within the last 14 days before randomization

• Concomitant aspirin and/or clopidogrel use;

• Persistent use of drugs with potential nephrotoxic effects (NSAIDs, cytotoxic drugs etc.);

• Need in anticoagulation treatment for disease other than AF

• Pregnancy and lactation;

• Creatinine clearance < 30 ml/min (by Cockroft - Gault equation)

• Thrombocytopenia of <100 *109 /л

• Hepatic failure B and C by Child-Pugh score

• Psychiatrist disorders

• Background poor compliance

• Known hypersensitivity to dabigatran, warfarin or their components

• Life expectancy less than two years