Nonvitamin K antagonist oral anticoagulant use in patients with renal impairment.

29 , 30 , 32 , 35 An interaction was observed for major bleeding with apixaban (interaction p value = 0.030); where patients with moderate renal impairment had a nominally significant greater reduction in major bleeding [hazard ration (HR): 0.53; 95% confidence interval (CI): 0.39–0.71], as compared with differences between apixaban and warfarin in patients with normal renal function (HR: 0.79; 95% CI: 0.61–1.04) and mild renal impairment (HR: 0.76; 95% CI: 0.62–0.94). 6 It is not known whether the observed benefit with apixaban is related to the molecule, to chance, other confounders, or possibly to a higher-than-expected bleeding rate with warfarin in the moderate renal subgroup of this trial ( Figure 10B ).

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