Weir MR, et al. - Among patients with non-valvular atrial fibrillation (NVAF) and stage IV-V chronic kidney disease (CKD) managed with rivaroxaban or warfarin, researchers compared the risks of ischemic stroke/systemic embolism (ISSE) and major bleeding. They used the Optum Deidentified EHR Database, to identify patients with NVAF and stage IV-V CKD who started rivaroxaban or warfarin therapy between November 2011 and June 2018. They propensity score-matched 781 eligible rivaroxaban-managed patients with 1,536 warfarin-treated patients. Following matching, baseline covariates were well balanced. For rivaroxaban vs warfarin, hazard ratios were estimated to be 0.93 for the risk of ISSE and 0.91 for major bleeding. Findings revealed that rivaroxaban- vs warfarin-treated patients did not show a statistically significant difference in the risk of ISSE or major bleeding. In the setting of NVAF and stage IV-V CKD, rivaroxaban seemed to afford a reasonable alternative to warfarin for the prevention of ISSE.