Role of Warfarin in Patients With Atrial Fibrillation on Dialysis: Meta-Analysis

Randhawa, M. S.; Vishwanath, Rohanlal; Manoj, P; Randhawa, Amritpal K.; Dhar, Gaurav

doi:10.1016/s0735-1097(19)31048-4

Cited by 2 publications

(1 citation statement)

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“…Several studies have investigated the association of warfarin with cardiovascular events protection in patients with AF and ESKD, but the results remain inconclusive [30,31]. In 2020, Randhawa et al [32] published a systematic review and meta-analysis on the prevention of ischemic strokes using warfarin in patients with ESKD and AF. They showed that among 15 studies with 47,480 patients, warfarin administration appears to be related to no change in the incidence of ischemic stroke, while it appears to be linked to a greater risk of hemorrhagic stroke, without affecting the risk of bleeding or all-cause mortal-ity.…”

Section: Warfarinmentioning

confidence: 99%

Direct Oral Anticoagulants in Patients on Chronic Dialysis and Concomitant Atrial Fibrillation: A Common Clinical Impasse

Ktenopoulos¹,

Sagris²,

Theofilis³

et al. 2022

Front. Biosci. (Schol Ed)

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The most frequent arrhythmia treated is atrial fibrillation (AF), which necessitates the use of oral anticoagulants (OACs) to reduce the risk of thromboembolism and stroke. Patients with chronic kidney disease are more likely to develop AF, with a 10% frequency among those on chronic dialysis. Warfarin is the most widely prescribed OAC for individuals with end-stage kidney disease (ESKD). On the other hand, direct OACs (DOACs) are generally safer than warfarin, with fewer fatal bleeding events and a fixed dose that does not require close international normalized ratio (INR) monitoring. For those patients, warfarin and apixaban appear to be FDA-approved, whereas dabigatran, rivaroxaban, and edoxaban are not recommended yet. Due to a lack of large randomized studies, data from major trials cannot be extended to dialysis patients. In this review, we summarize the available data and literature referring to patients on chronic hemodialysis with concomitant AF. Due to the scarcity of data, we try to assist clinicians in selecting the appropriate therapy according to the specific characteristics of each patient. Finally, future directions are provided in two key areas of focus: left atrial appendage closure therapies and genetic research.

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Section: Warfarinmentioning

confidence: 99%