Evidence map›Paper›PMID 31704740›Full record

Trial reportJournal of the American Society of Nephrology : JASN2020

Multicenter Randomized Controlled Trial of Vitamin K Antagonist Replacement by Rivaroxaban with or without Vitamin K2 in Hemodialysis Patients with Atrial Fibrillation: the Valkyrie Study.

An S De Vriese, Rogier Caluwé, Lotte Pyfferoen, Dirk De Bacquer, Koen De Boeck, Joost Delanote, Didier De Surgeloose, Piet Van Hoenacker, Bruno Van Vlem, Francis Verbeke

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Society of Nephrology : JASN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 15 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 15 syntheses or guidelines pooled it.

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  4. Anticoagulation for people receiving long-term haemodialysis.The Cochrane database of systematic reviews · 2024
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  15. Factor Xa Inhibitors Versus Vitamin K Antagonists in Atrial Fibrillation Patients with End-Stage Kidney Disease on Dialysis: A Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
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30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

An S De VrieseDivision of Nephrology and Infectious Diseases and an.devriese@azsintjan.be.ORCID 0000-0002-9596-8529
Rogier CaluwéDivision of Nephrology and.ORCID 0000-0002-4769-544X
Lotte PyfferoenDepartment of Medical Imaging, AZ Sint-Jan Brugge, Brugge, Belgium.
Dirk De BacquerPublic Health, Ghent University, Ghent, Belgium.
Koen De BoeckDivision of Nephrology and.
Joost DelanoteDepartment of Medical Imaging, AZ Sint-Jan Brugge, Brugge, Belgium.
Didier De SurgelooseDepartment of Medical Imaging, ZNA Middelheim, Antwerp, Belgium; and.
Piet Van HoenackerDepartment of Medical Imaging, Onze Lieve Vrouw Hospital, Aalst, Belgium.
Bruno Van VlemDivision of Nephrology and.
Francis VerbekeDivision of Nephrology, University Hospital, Ghent, Belgium.ORCID 0000-0003-2112-6326

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVitamin K antagonists (VKAs), although commonly used to reduce thromboembolic risk in atrial fibrillation, have been incriminated as probable cause of accelerated vascular calcification (VC) in patients on hemodialysis. Functional vitamin K deficiency may further contribute to their susceptibility for VC. We investigated the effect of vitamin K status on VC progression in 132 patients on hemodialysis with atrial fibrillation treated with VKAs or qualifying for anticoagulation.

methodsPatients were randomized to VKAs with target INR 2-3, rivaroxaban 10 mg daily, or rivaroxaban 10 mg daily plus vitamin K2 2000

resultsBaseline dp-ucMGP was severely elevated in all groups. Initiation or continuation of VKAs further increased dp-ucMGP, whereas levels decreased in the rivaroxaban group and to a larger extent in the rivaroxaban+vitamin K2 group, but remained nevertheless elevated. Changes in coronary artery, thoracic aorta, and cardiac valve calcium scores and pulse wave velocity were not significantly different among the treatment arms. All cause death, stroke, and cardiovascular event rates were similar between the groups. Bleeding outcomes were not significantly different, except for a lower number of life-threatening and major bleeding episodes in the rivaroxaban arms versus the VKA arm.

conclusionsWithdrawal of VKAs and high-dose vitamin K2 improve vitamin K status in patients on hemodialysis, but have no significant favorable effect on VC progression. Severe bleeding complications may be lower with rivaroxaban than with VKAs.

Indexed as

Atrial FibrillationRenal DialysisAgedAged, 80 and overAntifibrinolytic AgentsDrug Therapy, CombinationFactor Xa InhibitorsFemaleFibrinolytic AgentsHumansMaleProspective StudiesRivaroxabanStrokeVascular CalcificationVitamin KAntifibrinolytic AgentsFactor Xa InhibitorsFibrinolytic AgentsRivaroxabanVitamin KVitamin K 2direct oral anticoagulanthemodialysisoral anticoagulationvascular calcificationvitamin Kvitamin K antagonist

Identifiers

PMID31704740
PMCPMC6935010

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.