Project Lead: Dr Peter Gallacher

‘Atrial fibrillation’ is the term used to describe an irregular heartbeat, a common condition that often requires treatment with blood-thinning medication (‘anticoagulation’) to reduce the risk of stroke. Until recently, most patients were treated with blood-thinning medication called warfarin. However, patients taking warfarin need regular blood tests to monitor the drug levels and can require dose changes following these blood tests.

However, new drugs called ‘Direct Oral Anticoagulants’ (DOACs) have recently been developed. In patients with atrial fibrillation and normal kidney function, these drugs are as safe and effective as warfarin, but without the need for any blood tests or dose changes, making them much more acceptable to patients. Few studies have looked at whether these drugs are safe and effective in patients with either very bad or very good kidney function. This is important because these extreme levels of kidney function can be quite common – perhaps affecting ~1 in 5 patients – and also because DOACs are mostly removed from the body by the kidneys. Therefore, it is easy to appreciate that abnormal kidney function might impact on the amount of drug left in your

Here, we will use a large dataset containing a range of reliable and accurate data collected as part of patient care to improve our understanding of the safety and effectiveness of DOACs, compared to warfarin or no anticoagulation treatment, in patients with atrial fibrillation and abnormal kidney function."